利伐沙班和低分子肝素钙预防老年股骨粗隆间骨折术后深静脉血栓形成的效果比较  

Comparison of prophylactic effects of rivaroxaban and low molecular weight heparins calcium on deep vein thrombosis after surgery of femoral intertrochanteric fractures in the elderly patients

作　　者：黄永栋[1] 蒋卫平[2] 赵辉[1] 甘坤宁[2] 周竖平[2] 

机构地区：[1]宁波开发区中心医院关节外科,浙江宁波315800 [2]南宁市第二人民医院骨科

出　　处：《中国骨与关节损伤杂志》2016年第2期134-137,共4页Chinese Journal of Bone and Joint Injury

基　　金：广西南宁市科学研究与技术开发计划项目(ZC20123009)

摘　　要：目的 比较分析利伐沙班与低分子肝素钙预防老年股骨粗隆间骨折术后深静脉血栓形成（DVT）的疗效。方法 回顾性分析自2011-12—2013-12诊治70例股骨粗隆间骨折的临床资料,探讨术后采用利伐沙班（利伐沙班组）和低分子肝素钙（低分子肝素钙组）预防术后下肢DVT的疗效和安全性。结果 所有患者获得平均6（3~12）个月随访。2组DVT发生率比较：利伐沙班组中2例发生DVT（5.56%）;低分子肝素钙组中2例发生DVT（5.88%）,2组DVT发生率（χ~2=0.004,P=3.84）比较差异无统计学意义（P〉0.05）。2组血小板（PLT）、活化部分凝血活酶时间（APTT）值术后1 d、术后10 d与术前比较均有下降,差异有统计学意义（P〈0.05）,但术后1 d与术后10 d比较差异无统计学意义（P〉0.05）;2组谷丙转氨酶（ALT）值在术前、术后无明显变化,差异无统计学意义（P〉0.05）。2组均无大出血患者,术中出血量、术后引流量比较,差异无统计学意义（P〈0.05）。结论 本研究结果 表明应用利伐沙班与低分子肝素钙预防老年股骨粗隆间骨折术后DVT形成的对比研究中,二者均无术中、术后大出血,对肝肾功能均无影响,但利伐沙班对凝血功能影响更小。Objective To compare the effect of rivaroxaban and low molecular weight heparins calcium on preventing deep venous thrombosis （DVT） in elderly post-operative patients with intertrochanteric fractures. Methods Clinical data of 70 patients who underwent surgeries for intertrochanteric fractures from December 2011 to December 2013 were analyzed retrospectively. The patients were divided into rivaroxaban group and low moleeular weight heparins calcium group. Results All patients were followed up for 6 （3-12）months in the study. There was no significant difference in the incidence of DVT between the two groups（x2=0.004,P =3.84） and the incidence of DVT were 5.56%（2 cases） in rivaroxaban group and 5.88%（2 eases） in low molecular weight heparins calcium group, respectively. There were significant differences in platelet counts and APTT 1 day and 10 days after operations of the two groups compared with preoperative values（P 〈0.05） although no significant differences were observed in platelet counts and APTT between 1 day and 10 days after operations （P 〉0.05）. There were no significant differences in the postoperative level of serum ALT compared with preoperative values （P 〉0.05）. There was no massive hemorrhage in all patients and were no significant differences in intraoperative blood loss and postoperative drainage between the two groups. Conclusion Rivaroxaban has less effect on coagulation function without the added risk of bleeding and liver and kidney dysfunction in the prevention of deep vein thrombosis（DVT） after surgery of intertrochanterie fractures in the elderly patients.

关 键 词：股骨粗隆间骨折 利伐沙班 低分子肝素钙 深静脉血栓 

分 类 号：R619[医药卫生—外科学]