全髋关节置换前后联合用药预防静脉血栓栓塞  

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

作　　者：孙英华[1] 任金亭[1] 王莉[1] 王复超[1] 李冰[1] 焦兆德[1] 

机构地区：[1]潍坊医学院附属益都中心医院骨外科,山东省潍坊市262500

出　　处：《中国组织工程研究》2012年第52期9697-9701,共5页Chinese Journal of Tissue Engineering Research

基　　金：北京医学奖励基金会主办的全国骨科术后静脉血栓栓塞症预防相关课题方案优选大赛获奖课题;已列入山东省潍坊市卫生局科研项目计划(2012038)~~

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3656例,随机分试验组(n=1830)和对照组(n=1826),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。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.

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 

分 类 号：R687.4[医药卫生—骨科学]