利伐沙班预防全髋关节置换术后深静脉血栓的临床效果

目的 评价利伐沙班预防全髋关节置换术后深静脉血栓（DVT）的临床效果.方法 将312例行全髋关节置换术的患者随机分为对照组（皮下注射低分子肝素钙,n=156）和实验组（口服利伐沙班,n=156）.检测术前及术后14 d的凝血指标,B超检查评价DVT的发生情况.观察术后肺栓塞、严重器官出血及切口大血肿等并发症,记录术后24 h内切口引流量.结果两组术后14 d的凝血指标与术前比较差异无统计学意义（P〉0.05）,术后14 d两组间比较差异亦无统计学意义（P〉0.05）.实验组的DVT发生率低于对照组（P〈0.05）.两组均未出现肺栓塞、严重器官出血及切口大血肿;术后24 h两组引流量比较差异无统计学意义（P〉0.05）.结论利伐沙班可以有效预防全髋关节置换术后DVT的发生,抗凝效果显著优于低分子肝素钙,且不增加潜在的出血风险.

The clinical effect of rivaroxaban in prevention of deep venous thrombosis after total hip arthroplasty

Objective To evaluate the clinical effect of rivaroxaban in prevention of deep venous thrombosis （DVT） after total hip arthroplasty （THA）. Methods 312 patients who needed THA were randomized into control group （low molecular weight heparin by hypodemic injection ,n = 156） and experimental group （rivaroxaban by oral adminieration, n = 156）. The coagulation indexes were examined before and 14 days after surgery. B-ultrasound examination was used to evaluate the incident of DVT. The complications of severe postoperative organ bleeding and wound hema- toma, the incision drainage within 24 hours after surgery were observeed and recorded. Results There was no significant difference in coagulation indicators between before and 14 days after surgery in both control and experiment groups, and there was no significant difference in coagulation indicators 14 days after surgery between two groups （P 〉 0. 05 ）. The incidences of DVT in experiment group was significantly lower than that in control group （P 〈 0. 05 ）. No pulmonary embolism, serious organ bleeding and wound hematoma were observed in both groups, and there was no significant difference in incision drainage within 24 hours after surgery between the two groups （ P 〉 0. 05 ）. Conclusions Rivaroxaban can be more effective than low molecular weight heparin in preventing DVT after total hip arthro-plasty.