中国组织工程研究

中国组织工程研究 ›› 2013, Vol. 17 ›› Issue (30): 5440-5445.doi: 10.3969/j.issn.2095-4344.2013.30.004

• 人工假体 artificial prosthesis • 上一篇    下一篇

髋关节置换后应用利伐沙班预防深静脉血栓疗效及安全性分析

张  晖，王  东，孙海钰，栗树伟，刘  亮   

  1. 山西医科大学第二临床医学院，山西省太原市  030001
  • 收稿日期:2013-04-12 修回日期:2013-06-07 出版日期:2013-07-23 发布日期:2013-07-23
  • 通讯作者: 王东，主任医师，山西医科大学第二临床医学院，山西省太原市 030001 孙海钰，副主任医师，山西医科大学第二临床医学院，山西省太原市 030001
  • 作者简介:张晖★，男，1984年生，山西省太原市人，汉族，山西医科大学在读硕士，主要从事骨愈合机制方面的研究。 309889608@qq.com

Efficacy and safety of rivaroxaban in the prevention of deep vein thrombosis after hip arthroplasty

Zhang Hui, Wang Dong, Sun Hai-yu, Li Shu-wei, Liu Liang   

  1. Second Clinical Medical College of Shanxi Medical University, Taiyuan  030001, Shanxi Province, China
  • Received:2013-04-12 Revised:2013-06-07 Online:2013-07-23 Published:2013-07-23
  • Contact: Wang Dong, Chief physician, Second Clinical Medical College of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China Sun Hai-yu, Associate chief physician, Second Clinical Medical College of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
  • About author:Zhang Hui★, Studying for master’s degree, Second Clinical Medical College of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China 309889608@qq.com

PDF

839

被引次数

55

摘要：

背景：利伐沙班作为新型口服抗凝药物，在髋关节置换后预防下肢深静脉血栓疗效方面已得到广大学者研究证实。国外文献指出将疗程延长至35 d可更明显降低深静脉血栓发生率，在国内研究尚未明显结论，且延长疗程后药物安全性是否可靠仍未证实。
目的：比较利伐沙班与低分子肝素在髋关节置换后预防深静脉血栓的疗效及利伐沙班疗程用药安全性。
方法：选择2011年3月至2012年9月在山西医科大学第二临床医学院行初次单侧髋关节置换患者106例，随机等分为利伐沙班组和低分子肝素组，2组均在置换后6 h给药，利伐沙班组10 mg/d，疗程为5周；低分子肝素组4 100 U/d，疗程为2周。
结果与结论：利伐沙班组单侧髋关节置换患者置换后复查及随访均未发生深静脉血栓并且未发现深静脉血栓症状者，低分子肝素组单侧髋关节置换患者发现深静脉血栓7例(13%)，2组深静脉血栓发生率差异有显著性意义(P< 0.05)。2组单侧髋关节置换患者置换前后静脉血血红蛋白水平、血小板水平、凝血功能，以及置换后引流量和皮下瘀斑面积的差异均无显著性意义(P > 0.05)。提示髋关节置换后足疗程应用利伐沙班在预防深静脉血栓中具有明确的疗效，且足疗程应用利伐沙班有可靠的安全性。

关键词: 骨关节植入物, 人工假体, 深静脉血栓, 髋关节置换, 利伐沙班, 疗效, 安全性, 肝素

Abstract:

BACKGROUND: As an oral anticoagulant drug, many experiments have proved that rivaroxaban can prevent the deep venous thromboembolism after the hip arthroplasty. The foreign literatures indicate that it can significantly reduce the incidence of deep venous thromboembolism after extending the treatment course to 35 days. But there is no significant conclusion at home, and the safety of drugs after extentding the course has not been confirmed.
OBJECTIVE: To analyze the efficacy and safety of rivaroxaban versus low-molecular-weight heparin for the prevention of deep venous thrombosis after the hip arthroplasty.
METHODS: 106 patients with primary unilateral hip arthroplasty in the Second Clinical Medical College of Shanxi Medical University between March 2011 and September 2012 were selected. The patients were randomly divided into rivaroxaban group and low-molecular-weight heparin group. The patients in two groups were given drugs at 6 hours after replacement, the patients in the rivaroxaban group were given rivaroxaban 10 mg/d with the course of 5 weeks; the patients in the low-molecular-weight heparin group were given low-molecular-weight heparin 4 100 U/d with the course of 2 weeks.
RESULTS AND CONCLUSION: The review and follow-up results showed there was no deep vein thrombosis or symptoms of deep vein thrombosis in patients of the rivaroxaban group after replacement, while seven cases (13%) of deep vein thrombosis were observed in the low-molecular-weight heparin group, and there was significant difference in the incidence rate of deep vein thrombosis between two groups (P < 0.05). There were no significant differences in venous blood hemoglobin level, platelet level and coagulation function before and after replacement, as well as the drainage volume and subcutaneous ecchymosis area after replacement of the patients received unilateral hip arthroplasty between two groups (P > 0.05). The results indicate that full course of rivaroxaban has clear effect and reliable security in the prevention of deep venous thrombosis after hip arthroplasty.

Key words: bone and joint implants, artificial prosthesis, deep vein thrombosis, hip replacement, rivaroxaban, efficacy, safety, heparin

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