中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (52): 9697-9701.doi: 10.3969/j.issn.2095-4344.2012.52.002

• 人工假体 artificial prosthesis • 上一篇    下一篇

全髋关节置换前后联合用药预防静脉血栓栓塞

孙英华，任金亭，王 莉，王复超，李 冰，焦兆德   

  1. 潍坊医学院附属益都中心医院骨外科，山东省潍坊市 262500
  • 收稿日期:2012-04-17 修回日期:2012-06-24 出版日期:2012-12-23 发布日期:2012-12-23
  • 通讯作者: 焦兆德，主任医师，教授，硕士生导师，潍坊医学院附属益都中心医院骨外科，山东省潍坊市 262500 yiduh@163.com
  • 作者简介:孙英华☆，男，1976年生，山东省海阳市人，汉族，在读博士，副主任医师，主要从事关节外科方面的研究。 qzydsyh@163.com

Drug combination for preventing venous thromboembolism before and after total hip arthroplasty

Sun Ying-hua, Ren Jin-ting, Wang Li, Wang Fu-chao, Li Bing, Jiao Zhao-de   

  1. Department of Orthopedics, Affiliated Yidu Central Hospital of Weifang Medical University, Weifang 262500, Shandong Province, China
  • Received:2012-04-17 Revised:2012-06-24 Online:2012-12-23 Published:2012-12-23
  • Contact: Jiao Zhao-de, Chief physician, Professor, Master's supervisor, Department of Orthopedics, Affiliated Yidu Central Hospital of Weifang Medical University, Weifang 262500, Shandong Province, China yiduh@163.com
  • About author:Sun Ying-hua☆, Studying for doctorate, Associate chief physician, Department of Orthopedics, Affiliated Yidu Central Hospital of Weifang Medical University, Weifang 262500, Shandong Province, China qzydsyh@163.com

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685

被引次数

1

摘要：

背景：目前大多数医院采取全髋关节置换后应用抗凝药物方案来预防静脉血栓栓塞，但仍存在一定的静脉血栓栓塞发生率，能否采用置换前后联合用药方案，既不增加出血风险又能更好地降低静脉血栓栓塞发生率？
目的：比较置换前维生素E联合置换后利伐沙班与仅置换后利伐沙班预防全髋关节置换后静脉血栓栓塞的有效性及安全性。
方法：选择2010年1月至2012年3月在潍坊医学院附属益都中心医院等4所医院的全髋关节置换患者3 656例，随机分试验组(n=1 830)和对照组(n=1 826)，前者置换前给予维生素E联合置换后给予利伐沙班，后者置换前给予安慰剂联合置换后给予利伐沙班。
结果与结论：与对照组相比，试验组总静脉血栓栓塞事件发生率低(P < 0.01)，而大出血事件发生率二者接近(P > 0.05)。说明置换前维生素E联合置换后利伐沙班比仅置换后利伐沙班可更有效预防全髋关节置换后静脉血栓栓塞的发生，且并未额外增加出血风险。

关键词: 维生素E, 利伐沙班, 全髋关节置换, 静脉血栓栓塞, 联合应用, 疗效, 医学植入体

Abstract:

BACKGROUND: Currently, the antithrombotic are commonly used for the prevention of venous thromboembolism after total hip arthroplasty, but there is still a certain incidence of venous thromboembolism. Is it possible to reduce the incidence of venous thromboembolism better while not increasing the risk of bleeding if some drugs are applied combinedly before and after operation?
OBJECTIVE: To compare the efficacy and safety of preventing venous thromboembolism after total hip arthroplasty by applying preoperation vitamin E combined with postoperation rivaroxaban versus postoperation rivaroxaban alone.
METHODS: Totally 3 656 patients undergoing total hip arthroplasty in four hospitals, including Affiliated Yidu Central Hospital of Weifang Medical University from January 2010 to March 2012 were randomly divided into experimental group (n=1 830) and control group (n=1 826). The experimental group was given preoperation vitamin E combined with postoperation rivaroxaban therapy, while the control group was given preoperation placebo combined with postoperation rivaroxaban therapy.
RESULTS AND CONCLUSION: Compared with the control group, the incidence of total venous thromboembolism event was lower in the experimental group (P < 0.01), but the incidence of major bleeding event was approximate in two groups (P > 0.05). It indicates that preoperation vitamin E combined with postoperation rivaroxaban can be more effective after total hip arthroplasty than only postoperation rivaroxaban applying in preventing venous thromboembolism, without an extra risk of bleeding.

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