利伐沙班和低分子肝素预防关节镜下膝多发韧带损伤重建术后下肢深静脉血栓的前瞻性随机对照研究  

Rivaroxaban versus low molecular weight heparin in prevention of venous thromboembulism in patients undergoing arthroscopy knee multiple ligament reconstruction

作　　者：刘亮[1] 成文浩[1] 裴征[1] 桂琦[1] 赵峰[1] 张星火[1] 

机构地区：[1]首都医科大学附属北京潞河医院骨关节和运动医学科,北京101149

出　　处：《临床药物治疗杂志》2016年第6期17-20,共4页Clinical Medication Journal

基　　金：首都医科大学附属北京潞河医院科研专项

摘　　要：目的:采用前瞻性随机对照研究分析的方法比较利伐沙班与低分子肝素(LMWH)对膝关节镜下多发韧带损伤重建术后下肢深静脉血栓发病率的影响,探讨利伐沙班在预防膝关节镜下多发韧带重建手术后下肢深静脉血栓(DVT)的疗效和安全性。方法:选取2015年1月~2016年6月首都医科大学附属北京潞河医院运动医学科收治的105例行关节镜下膝多发韧带损伤重建手术的患者,随机分成3组:利伐沙班组(A组):术后给予利伐沙班10mg,1次/d。经口服;LMWH组(B组):术后给予LMWH 100 u·kg^(-1),1次/d,皮下注射;对照组(C组):采用物理和机械预防。结果:105名患者中发生DVT13例,其中利伐沙班组2例,LMWH组2例,对照组9例。无肺栓塞及死亡病例。3组患者围手术期失血量差异均无统计学意义(P>0.05)。利伐沙班组和LMWH组DVT发生率无统计学意义(P>0.05),利伐沙班组和LMWH组DVT发生率与对照组相比均有显著性差异(P<0.05),3组患者均未发生症状性肺栓塞,没有死亡病例。结论:利伐沙班和低分子肝素(LMWH)都可以有效预防患者膝关节镜下多发韧带重建术后下肢深静脉血栓的发生,利伐沙班有较好的安全性,并不增加出血风险。Objective： To compare the effects and savety of rivaroxaban and low molecular weight heparin on Preventing deep venous thrombosis after arthroscopy knee multiple ligament reconstruction. Methods： Totally 105 athroscopic patients undergoing arthroscopic reconstruction of multiple ligament injury from January 2015 to June 2016 were randomized into tnree groups： A Rivaroxaban group was treated by Rivaroxaban 10 mg orally once daily. Oral administration; B. LMWH group treated by postoperative subcutaneously injection of LMWH 100 u·kg^（-1） once daily Subcutaneous injection; C. control group： with the use of physical and mechanical prevention.Results： 13 patients had DVT among 105 patients, including 2（35） cases in Rivaroxaban group, 2（35） cases in LMWH group and 9（35）cases in the control group. There was no pulmonary embolism and death. There was no significant difference in perioperative blood loss between three groups（P0.05）. The incidence of DVT between Rivaroxaban group and LMWH group showed no statistical significance（P0.05）, and there was significant difference in the incidence of DVT between Rivaroxaban group and LMWH group, the incidence rate of DVT compared with the control group there were（P 0.05）, and there was no symptomatic pulmonary embolism and no deaths among three groups. Conclusion： Rivaroxaban and low molecular weight heparin（LMWH） can effectively prevent deep venous thrombosis in patients undergoing knee arthroscopic multiple ligament reconstruction, and Rivaroxaban showed better safety without increasing the risk of bleeding.

关 键 词：下肢深静脉血栓 低分子肝素 利伐沙班 多发韧带损伤重建术 关节镜 

分 类 号：R873[医药卫生—运动医学]