利伐沙班预防膝关节置换术后深静脉血栓形成50例疗效及安全性评价

Effect of Rivaroxaban for Preventing Postoperative Deep Vein Thrombosis Prophylaxis after Knee Arthroplasty in 50 Cases

目的观察利伐沙班预防人工全膝关节置换术后深静脉血栓形成的临床疗效及安全性。方法将医院收治的人工全膝关节置换术患者100例随机分为对照组(低分子肝素钙组)和观察组(利伐沙班组),各50例,比较两组术后深静脉血栓形成发生率、深静脉血栓形成的早期诊断指标水平、血液流变学指标变化情况。结果观察组术后14,21 d深静脉血栓形成发生率显著低于对照组(P<0.05),术后3 d D-dimer、同型半胱氨酸、CRP水平均明显低于对照组(P<0.05);血细胞比容、全血黏度、纤维蛋白原等血液流变学指标均明显低于对照组(P<0.05)。结论利伐沙班能有效预防人工全膝关节置换术后深静脉血栓的形成,改善机体的高凝状态,具有较高的安全性,值得临床推广。

Objective To observe the efficacy and safety of rivaroxaban for preventing postoperative deep vein thrombosis prophylaxis undergoing artificial total knee arthroplasty. Methods 100 patients with artificial total knee arthroplasty in our hospital were randomized into the control group( low molecular weight heparin) and the observation group( rivaroxaban),50 patients in each group. The incidence of postoperative deep vein thrombosis prophylaxis,the levels of early diagnosis index of deep vein thrombosis prophylaxis,and the changes of blood rheology index in two groups were compared. Results The incidences of deep vein thrombosis prophylaxis on 14 d and 21 d after operation in the observation group were significantly less than those in the control group( P < 0. 05); the levels of D- dimer,homocysteine and CRP on 3 d after operation in the observation group were significantly less than those in the control group( P < 0. 05); the levels of blood rheology index such as hematccrit,whole blood viscosity and fibrinogen in the observation group were significantly less than those in the control group( P < 0. 05). Conclusion Rivaroxaban can effectively prevent the incidence of deep vein thrombosis prophylaxis after artificial total knee arthroplasty,and improve the blood hyper- coagulation state with higher safety,it is worthy of clinical promotion.