利伐沙班预防髋关节置换术后下肢深静脉血栓的临床效果

Effect analysis of rivaroxaban applied on patients with hip replacement to prevent deep venous thrombo-sis after treatment

目的：探讨利伐沙班预防髋关节置换术后下肢深静脉血栓的临床效果。方法将108例接受髋关节置换术患者按照随机数字表法分为对照组和研究组，每组54例。对照组患者术后给予低分子肝素皮下注射，连用2周；研究组患者术后给予利伐沙班口服，连用5周。比较两组患者围术期出血量、术后引流量、治疗前后PLT及凝血功能变化，以及下肢深静脉血栓发生率的差异。结果对照组围术期出血量及术后引流量分别为（1259?45±56?73） ml和（176?45±31?59） ml，研究组围术期出血量及术后引流量分别为（1248?69±49?58） ml和（164?25±29?58） ml；两组间围术期出血量及术后引流量比较差异均无统计学意义（t值分别为0?986和0?965， P均＞0?05）。两组患者治疗前后PLT[对照组治疗前后分别为（211?58±35?64）、（205?58±24?68）×109／L；观察组治疗前后分别为（209?58±24?76）、（204?52±19?46）×109／L]及凝血功能[PT：对照组治疗前后分别为（12?65±1?54）、（12?97±1?62） s，观察组治疗前后分别为（12?59±0?96）、（12?84±1?04） s；APTT：对照组治疗前后分别为（27?84±5?48）、（28?06±4?28） s，观察组治疗前后分别为（27?57±4?26）、（28?04±5?06） s]变化差异均无统计学意义（ P 均＞0?05），治疗后两组间比较差异也无统计学意义（ t值分别为0?165、0?469和0?635，P均＞0?05）。对照组与研究组术后下肢深静脉血栓发生率分别为9?26％（5／54）和7?41％（4／54），两组间比较差异无统计学意义（χ2＝0?125，P＞0?05）。两组患者治疗期间均未发生肺栓塞。结论利伐沙班预防髋关节置换术后下肢深静脉血栓疗效与低分子肝素相当，但是具有用药方便的优势，为预防髋关节置换术后下肢深静脉血栓的形成增加了一种选择。

Objective To discuss the clinical effect of rivaroxaban applied on patients with hip replace?ment to prevent deep venous thrombosis( DVT) after treatment?Methods One hundred and eight cases patients with hip replacement were divided into the control group(n=54) and research group(n=54) according to the random number table method?The patients of the control group were given low molecular weight heparin subcuta?neous injection for 2 weeks,while the patients of the research group were given oral rivaroxaban for 5 weeks?The perioperative blood loss,postoperative flow,the platelet count ( PLT) and blood coagulation function changes of before and after treatment and the incidence of DVT of the two groups were compared?Results The periopera?tive blood loss and postoperative flow of the control group were respectively (1 259?45±56?73) ml and(176?45 ±31?59) ml,of the research group were respectively(1 248?69±49?58) ml and (164?25±29?58) ml,there were no statistical significance between the two groups( t=0?986,0?965,P>0?05)?Before and after treatment in both two groups,there were no statistical difference in terms of PLT ( before and after treatment of the control group were respectively (211?58±35?64)×109/L,(205?58±24?68)×109/L,before and after treatment of the research group were respectively (209?58±24?76) ×109/L,(204?52±19?46) ×109/L),coagulation function (before and after treatment of the control group were respectively (12?65±1?54) s,(12?97±1?62) s,before and after treatment of the research group were respectively (12?59±0?96) s,(12?84±1?04) s) and APTT(be?fore and after treatment of the control group were respectively (27?84±5?48) s,(28?06±4?28) s,before and af?ter treatment of the research group were respectively (27?57±4?26) s,(28?04±5?06) s),the differences be?tween the two groups had no statistical significance( t=0?165,0?469,0?635,P>0?05)?The incidence of DVT of the research group and control group were respectively 9?26%(5/54) and 7?41%(4/54),the differences were no statistical significance(χ2=0?125,P<0?05)?Conclusion The clinical effect of rivaroxaban applied on pa?tients with hip replacement to prevent deep venous thrombosis after treatment is equivalent to low molecular weight heparin,but has the advantage of convenience use of medicine,so it is worth popularization and applica?tion.