小剂量低分子肝素钙与利伐沙班结合常规方法预防高龄髋部骨折患者深静脉血栓形成的临床效果比较  

Comparison of the clinical effects between small-dose low-molecular-weight heparin calcium and rivaroxaban combined with conventional methods on the prevention of deep venous thrombosis in elderly patients with hip fractures

作　　者：李德剑[1] 陈武[1] 刘昌生[1] 黄永森[1] 杨小平[1] 黎忠文[1] 赵凤[1] 

机构地区：[1]玉林市中西医结合骨科医院内科,广西537000

出　　处：《中国临床新医学》2017年第2期124-126,共3页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：广西玉林市科学研究与技术开发计划项目(编号:玉科计字20145001)

摘　　要：目的观察小剂量低分子肝素钙(low-molecular-weight heparin calcium,LMWH)、利伐沙班(rivaroxaban)结合常规预防方法预防高龄髋部骨折(包括股骨颈骨折及股骨粗隆间骨折)患者下肢深静脉血栓形成的疗效。方法选2014-01~2015-02高龄(均≥75岁)髋部骨折患者106例,用随机数字表法随机分为小剂量LMWH组56例和利伐沙班组50例,观察两组预防下肢深静脉血栓形成的有效率及并发症的发生率。结果预防下肢深静脉血栓形成有效率小剂量LMWH组为89.3%,利伐沙班组为90.0%(P>0.05);出现切口大渗血的发生率小剂量LMWH组为0.0%,利伐沙班组为10.0%(P<0.05);引起凝血酶原时间延长的发生率小剂量LMWH组为1.8%,利伐沙班组为6.0%(P>0.05)。结论两组结合常规预防方法预防高龄髋部骨折患者下肢深静脉血栓形成均有良好疗效,而小剂量LMWH组切口大渗血并发症发生率比利伐沙班组低。Objective To compare the clinical effects between small-dose low-molecular-weight heparin calcium（LMWH） and rivaroxaban combined with conventional methods on the prevention of deep venous thrombosis in elderly patients with hip fractures（including femoral neck fracture and femoral intertrochanteric fracture）. Methods One hundred and six patients（aged ≥75 years） with hip fractures from January 2014 to February 2015,were randomly divided into the small-dose LMWH group（n = 56） and the rivaroxaban group（n = 50）. The efficiency and complication rate of prevention of lower extremity deep venous thrombosis were compared between the two groups. Results There was no significant difference in the effective rate between the small dose LMWH group（89. 3%） and the rivaroxaban group（90. 0%）（P〉0. 05）. The bleeding complication rate of the small-dose LMWH group（0. 0%） was significantly lower than that of the rivaroxaban group（10. 0%）（P〈0. 05）. There was no significant difference in the incidence of prolonged prothrombin time between the small-dose LMWH group（ 1. 8%） and the rivaroxaban group（ 6. 0%）（ P〈0. 05）. Conclusion Both of small-dose low-molecular-weight heparin calcium and rivaroxaban combined with conventional methods are effective for preventing hip fractures in the elderly patients with lower extremity deep venous thrombosis. The bleeding complication rate in the small-dose LMWH group is lower than that in the rivaroxaban group.

关 键 词：小剂量低分子肝素钙 利伐沙班 髋部骨折 下肢深静脉血栓 

分 类 号：R68[医药卫生—骨科学]