利伐沙班与依诺肝素预防髋关节置换术后下肢深静脉血栓形成的对照研究

目的比较利伐沙班与依诺肝素预防股骨颈骨折人工全髋关节置换术后下肢深静脉血栓形成（DVT）的有效性及安全性。方法选取本院2012年7月至2013年7月收治的105例股骨颈骨折行人工全髋关节置换术的老年患者为研究对象,经患者及家属知情同意用药方案,将以上患者分为利伐沙班组和依诺肝素组。通过观察两组患者术后静脉血栓栓塞症（VTE）的相关临床症状及体征,行血管彩超及 CTA检查诊断统计 DVT和肺栓塞（PE）例数,评价其有效性。统计两组患者出血事件、额外输血率评价其安全性。结果两组患者均没有出现PE,均无出现大出血事件。而DVT的发生率,一般出血事件发生率,额外输血率,两组比较差异均无统计学意义（P ＞0.05）。结论利伐沙班对比依诺肝素,对老年股骨颈骨折患者行人工全髋关节置换术后预防 VTE 发生具有同样良好的效果,并且未增加出血风险。

Comparative Study of Rivaroxaban vs.Enoxaparin for Preventing Venous Thrombosis of Lower Limbs After Total Hip Replacement

Obj ective]To compare the effectiveness and safety of rivaroxaban vs.enoxaparin in the prophylax-is of deep venous thromboembolism（DVT）of lower limbs in femoral neck fracture after total hip replacement.Methods]Totally 105 elderly patients with femoral neck fracture undergoing total hip replacement in our hospital from July 2012 to July 2013 were enrolled in the study.After the informed consent of patients and their families to the treatment schedule,above patients were divided into rivaroxaban group and enoxaparin group.Clinical symp-toms and signs related to VTE of patients in 2 groups after operation were observed.Vascular color Doppler ultra-sonography and CT angiography（CTA）were performed to calculate the number of DVT and pulmonary embolism （PE）.The effectiveness was assessed.The bleeding events and additional transfusion rate were calculated to as-sess the safety.Results]No PE and large hemorrhage event were found in two groups.There was no significant difference in the incidence of DVT and common bleeding events and additional transfusion rate between two groups （P 〉0.05）.Conclusion]Rivaroxaban for preventing DVT in elderly patients with femoral neck fracture after to-tal hip replacement has the same efficacy as enoxaparin without increasing bleeding risk.