中国组织工程研究

中国组织工程研究 ›› 2014, Vol. 18 ›› Issue (22): 3456-3462.doi: 10.3969/j.issn.2095-4344.2014.22.003

• 人工假体 artificial prosthesis • 上一篇    下一篇

切/刮除膝关节周围原发骨肿瘤置入假体或钢板后抗凝：利伐沙班的效果

王 倩1，王 臻1，郭 征1，陈国景1，王财儒1，林 瑶2，吴智钢1   

  1. 1解放军第四军医大学西京医院骨科，陕西省西安市 710032；2解放军第518医院超声科，陕西省西安市 710043
  • 修回日期:2014-04-09 出版日期:2014-05-28 发布日期:2014-05-28
  • 通讯作者: 王臻，主任医师，教授，博士生导师，解放军第四军医大学西京医院骨科，陕西省西安市 710032 并列通讯作者：吴智钢，博士，主治医师，解放军第四军医大学西京医院骨科，陕西省西安市 710032
  • 作者简介:王倩，女，1977年生，辽宁省朝阳市人，汉族，解放军第四军医大学在读硕士，主管护师，主要从事骨科临床与基础研究工作。

Anticoagulant after prosthetic implantation or plate fixation for resection/curettage of primary bone tumor around the knee joint: effect of rivaroxaban

Wang Qian1, Wang Zhen1, Guo Zheng1, Chen Guo-jing1, Wang Cai-ru1, Lin Yao2, Wu Zhi-gang1   

  1. 1Department of Orthopedics, Xijing Hospital, Fourth Military Medical University of Chinese PLA, Xi’an 710032, Shaanxi Province, China; 2Department of Ultrasound, the 518 Hospital of Chinese PLA, Xi’an 710043, Shaanxi Province, China)
  • Revised:2014-04-09 Online:2014-05-28 Published:2014-05-28
  • Contact: Wang Zhen, Chief physician, Professor, Doctoral supervisor, Department of Orthopedics, Xijing Hospital, Fourth Military Medical University of Chinese PLA, Xi’an 710032, Shaanxi Province, China Corresponding author: Wu Zhi-gang, M.D., Attending physician, Department of Orthopedics, Xijing Hospital, Fourth Military Medical University of Chinese PLA, Xi’an 710032, Shaanxi Province, China
  • About author:Wang Qian, Studying for master’s degree, Nurse-in-charge, Department of Orthopedics, Xijing Hospital, Fourth Military Medical University of Chinese PLA, Xi’an 710032, Shaanxi Province, China

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摘要：

背景：对于膝关节周围原发骨肿瘤患者，行肿瘤假体置入和病变切/刮除植骨钢板内固定后极易发生深静脉血栓，临床中应给予足够重视。

目的：探讨成人膝部原发性骨肿瘤切/刮除行假体置换或钢板内固定后应用利伐沙班预防血凝的有效性及安全性。
方法：2011年3月至2012年3月解放军第四军医大学西京医院骨与软组织肿瘤科收治首诊为膝关节周围原发性骨肿瘤的成年患者，随机入选40例治疗前均无深静脉血栓的患者，再随机分为2组，其中对照组20例，膝部原发性骨肿瘤切/刮除行假体置换或钢板内固定后予以常规护理及物理预防措施；治疗组20例，在对照组治疗的基础上，服用利伐沙班10 mg/d口服，连续14 d。治疗后1个月随访评价深静脉血栓形成情况及深静脉血栓发生率，并观察两组患者有无肺动脉栓塞和严重出血事件的发生。

结果与结论：治疗组发生深静脉血栓0例，对照组发生深静脉血栓2例；两组均未发生肺动脉栓塞和严重出血事件。两组深静脉血栓发生率比较，差异有显著性意义(P < 0.05)。结果提示利伐沙班可有效降低膝关节周围原发性骨肿瘤患者治疗后深静脉血栓的发生，具有良好的预防作用和安全性。


中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程


全文链接：

关键词: 植入物, 人工假体, 骨肿瘤, 膝关节周围, 利伐沙班, 深静脉血栓

Abstract:

BACKGROUND: In patients with primary bone tumor around the knee joint, deep venous thrombosis easily occurred after prosthetic implantation, lesion resection/curettage, bone grafting and plate fixation. Thus, this should be paid enough attention in the clinic.

OBJECTIVE: To explore effectiveness and safety of rivaroxaban to prevent the deep vein thrombosis of adult lap in patients with primary bone tumors undergoing prosthetic replacement or plate fixation after resection/curettage tumors.
METHODS: Forty adult patients with primary bone tumor around the knee joint diagnosed in Department of Bone and Soft Tissue Oncology, Xijing Hospital, Fourth Military Medical University of Chinese PLA from March 2011 to March 2012 were randomly enrolled in this study. They did not have affected deep venous thrombosis before treatment. They were randomly assigned to two groups. Control group (n=20) received lesion resection/curettage, prosthetic replacement or plate fixation, and then received usual care and physical prophylaxis. Treatment group (n=20) received rivaroxaban 10 mg/d orally for 14 days, besides the treatment in the control group. At 1 month after treatment, deep venous thrombosis and the incidence of deep venous thrombosis were evaluated in follow-up. Whether pulmonary embolism and severe hemorrhage occurred was observed in both groups.
RESULTS AND CONCLUSION: None deep venous thrombosis developed in the treatment group, however, two patients with deep venous thrombosis were found in the control group. There was no pulmonary embolism or severe hemorrhage in both groups. There was significant difference in the incidence of deep venous thrombosis between both groups (P < 0.05). Results suggested that rivaroxaban effectively reduced the occurrence of deep venous thrombosis in the patients with primary bone tumor around the knee joint, and showed good prevention and safety.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程


全文链接：

Key words: bone neoplasms, knee joint, venous thrombosis, anticoagulants

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