TKA术后应用阿司匹林、低分子肝素钙和利伐沙班预防VTE疗效分析

Efficacy analysis of Aspirin, LWHC and Rivaroxaban in prevention of VTE after TKA

目的通过病例分组对照比较阿司匹林、低分子肝素钙和利伐沙班在应用于膝关节置换术后的抗凝疗效。方法选定2017年8月—2018年6月于郑州大学第一附属医院行初次全膝关节置换术的135例患者为研究对象,按随机数字表法均分为A组、B组和C组。A组(n=45,术后服用阿司匹林);B组(n=45,术后皮下注射低分子肝素钙);C组(n=45,术后服用利伐沙班),比较三组患者术后下肢肌间静脉血栓形成情况、术后血红蛋白下降量、引流量及术后出血量。结果三组患者肌间静脉血栓发生率差异对比无统计学意义(P>0.05),三组患者术后血红蛋白下降量、引流量及术后出血量差异对比无统计学意义(P>0.05)。结论阿司匹林、低分子肝素钙及利伐沙班均能有效的预防膝关节置换术后深静脉血栓的发生,并有着类似的治疗效果。

Objective To compare the anticoagulant effects of aspirin,LWHC and rivaroxaban in the treatment of knee arthroplasty by case-controlled study.Methods Totally 135 patients who underwent primary total knee arthroplasty in our hospital from September 2017 to August 2018 were selected as study subjects,and were divided into group A,group B and group C according to the random number table method.Group A(n=45,taking aspirin after surgery);Group B(n=45,subcutaneous injection of low molecular heparin calcium after surgery);In group C(n=45,taking rivaroxaban postoperatively),patients in the three groups were compared with postoperative intramuscular vein thrombosis,postoperative hemoglobin decrease,drainage volume and postoperative blood loss.Results There was no statistically significant difference in the incidence of intramuscular venous thrombosis between the groups A,B and C(P>0.05);There was no statistically significant difference in postoperative hemoglobin decrease and drainage volume between group A,B and C(P>0.05);There was no significant difference in postoperative blood loss between group A,B and C(P>0.05).Conclusion Aspirin,LMWC and rivaroxaban are effective in preventing deep vein thrombosis after knee replacement and have similar therapeutic effects.