低分子肝素及利伐沙班预防全髋关节置换术后失血的观察  

The Observation of Low Molecular Weight Heparin and Rivaroxaban on Blood Loss after Total Hip Arthroplasty

作　　者：孟庆奇 张延祠 王敏[1] 张勋梦 奉振成 李斯明[1] 

机构地区：[1]广州市红十字会医院,广东广州510220 [2]石家庄市第二人民医院,河北石家庄050051

出　　处：《现代临床医学》2015年第4期249-251,共3页Journal of Modern Clinical Medicine

摘　　要：目的:探讨人工全髋关节置换患者术后应用低分子肝素或利伐沙班对术后出血量的影响。方法:回顾性分析2012年2月至2014年2月共240例行人工全髋关节置换患者,按术后是否应用低分子肝素或利伐沙班分为空白对照组、低分子肝素组及利伐沙班组。统计比较各组术后血红蛋白、血小板的变化及术后总失血量、显性失血量及隐性失血量。结果:低分子肝素组总失血量明显高于对照组(P<0.01),利伐沙班组总失血量明显高于对照组(P<0.01)。低分子肝素组及利伐沙班组的显性失血量及隐性失血量也明显高于对照组。低分子肝素组与利伐沙班组出血量无明显差异。3组患者中隐性失血量占总失血量的比例无明显差异。结论:髋骨关节置换术后应用低分子肝素及利伐沙班可增加失血量,包括隐性失血量的增加,2种抗凝药物的疗效相当,应密切关注血红蛋白及血小板的变化,充分认识隐性失血,对患者有效血容量的丢失作出正确评估。Objective： To explore the effect of low molecular weight heparin and rivaroxaban on blood loss after total hip arthroplasty. Methods ：240 total hip replacement patients from February 2012 to February 2014 were retrospectively analyzed; the patients were divided into control group, LMWH group and rivaroxaban group ; and analysed the perioperative hemoglobin and platelets and total blood loss, dominant blood loss and hidden blood loss in three groups. Results： The total blood loss and dominant and hidden blood loss of LMWH group and rivaroxaban group were significantly higher than that of the control group（ P 〈0. 01 ） . However,there were no significant differences between LMWH group and rivaroxaban group in the dominant and hidden blood loss. Conclusion：Using low molecular weight heparin and rivaroxaban after Hip arthroplasty can increase blood loss. The two anticoagulant drugs have same efficacy . We should pay close attention to the changes of hemoglobin and plateletand be aware of hidden blood loss, have a correct assessment of effective blood volume in patients.

关 键 词：全髋关节置换 低分子肝素 利伐沙班 隐性失血 

分 类 号：R681.6[医药卫生—骨科学]