中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (9): 1618-1621.doi: 10.3969/j.issn.1673-8225.2012.09.023

• 骨与关节循证医学 evidence-based medicine of the bone and joint • 上一篇    下一篇

全髋关节置换后应用利伐沙班安全性的Meta分析☆

李  军，王  健，史占军，李  阳   

  1. 南方医科大学南方医院关节与骨病外科，广东省广州市  510515
  • 收稿日期:2011-09-03 修回日期:2011-10-27 出版日期:2012-02-26 发布日期:2012-02-26
  • 通讯作者: 史占军，教授，博士生导师，南方医科大学南方医院关节与骨病外科，广东省广州市 510515 zhanjunshi@yahoo.com.cn
  • 作者简介:李军☆，男，1987年生，安徽省合肥市人，汉族，南方医科大学2004级临床医学八年制在读，博士，主要从事关节损伤、功能重建及康复的研究。junliarmy@163.com

Meta-analysis of rivaroxaban safety after total hip arthroplasty

Li Jun, Wang Jian, Shi Zhan-jun, Li Yang   

  1. Department of Orthopaedic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou  510515, Guangdong Province, China
  • Received:2011-09-03 Revised:2011-10-27 Online:2012-02-26 Published:2012-02-26
  • Contact: Shi Zhan-jun, Professor, Doctoral supervisor, Department of Orthopaedic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China zhanjunshi@yahoo.com.cn
  • About author:Li Jun☆, Studying for doctorate, Department of Orthopaedic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China junliarmy@163.com

PDF

321

摘要：

背景：利伐沙班预防全髋关节置换后静脉血栓的疗效已经得到诸多实验的证明，但有关其安全性实验结果并不一致。
目的：系统评价利用伐沙班和依诺肝素预防全髋关节置换后静脉血栓的安全性。
方法：全面检索国内外关于利伐沙班和依诺肝素预防全髋关节置换术后静脉血栓的随机对照研究文献，筛选出符合评价标准的文献，采用RevMan 5.1软件进行Meta分析。
结果与结论：纳入随机对照研究文献6篇，其中5篇英文和1篇中文，全部样本量合计9 611例。荟萃分析结果显示：全髋关节置换后应用利伐沙班的大出血事件发生率高于依诺肝素，RR为1.75 (95%CI，0.76~4.04)，Z=1.31(P=0.19)；临床非大出血事件发生率高于依诺肝素，RR为1.29 (95%CI，0.99~1.68)，Z=1.85(P=0.06)；小出血事件发生率稍低于依诺肝素，RR为0.98 (95%CI，0.76~1.25)，Z=0.20(P=0.84)；总出血事件发生率稍高于依诺肝素，RR为1.13(95%CI，0.95~1.35)，Z=1.38(P=0.17)。提示全髋关节置换后使用利伐沙班预防静脉血栓栓塞的安全性与依诺肝素相当，差异无显著性意义。
关键词：利伐沙班；依诺肝素；全髋关节置换；静脉血栓栓塞；系统评价
doi:10.3969/j.issn.1673-8225.2012.09.023

关键词: 利伐沙班, 依诺肝素, 全髋关节置换, 静脉血栓栓塞, 系统评价

Abstract:

BACKGROUND: Many experiments have proved that rivaroxaban can prevent the venous thromboembolism after total hip arthroplasty, but its safety has not been confirmed.
OBJECTIVE: To systematically review the safety of rivaroxaban and enoxaparin for prevention of venous thromboembolism after total hip arthroplasty.
METHODS: We searched the documents about the safety of rivaroxaban and enoxaparin in the prevention of venous thromboembolism after total hip arthroplasty at home and abroad. Selected the literatures met evaluation criteria and made a Meta-analysis by RevMan 5.1 software.
RESULTS AND CONCLUSION: Six randomized controlled trials involving 9 611 patients were included in our Meta-analysis, five in English and one in Chinese. The results showed the incidence of major bleeding event of rivaroxaban was higher than that of enoxaparin after total hip arthroplasty, RR was 1.75 (95%CI, 0.76-4.04), Z=1.31(P=0.19); clinically relevant non-major bleeding incidence of rivaroxaban was higher than that of enoxaparin, RR was 1.29 (95%CI, 0.99-1.68), Z=1.85(P=0.06); the minor bleeding event incidence of rivaroxaban were lower than that of enoxaparin, RR was 0.98 (95%CI, 0.76-1.25), Z=0.20(P=0.84); total bleeding events incidence of rivaroxaban were higher than enoxaparin, RR was 1.13 (95%CI, 0.95-1.35), Z=1.38(P=0.17). The safety of rivaroxaban in the prevention of venous thromboembolism after total hip arthroplasty was corresponding to enoxaparin, and the difference was not significant.

中图分类号: