利伐沙班预防关节置换术后深静脉血栓的形成  

Prevention of Deep Vein Thrombosis after Total Joint Replacement by Rivaroxaban

作　　者：郭书英 吴传亮 魏强[1] GUO Shu-ying;WU Chuan-liang;WEI Qiang(Department of Pharmacy,the 88th Hospital of PLA,Taian 271000,China)

机构地区：[1]解放军88医院药剂科,山东泰安271000

出　　处：《解放军药学学报》2018年第4期377-379,共3页Pharmaceutical Journal of Chinese People's Liberation Army

摘　　要：目的探讨利伐沙班预防关节置换术后深静脉血栓形成的有效性和安全性。方法选择2017年1月—2018年1月在解放军88医院行全髋或全膝关节置换术患者60例,患者随机分为两组,对照组患者术后12h皮下注射低分子肝素钙注射液,观察组患者术后12h口服利伐沙班片,术后第5天双下肢彩超检查是否有血栓形成,分析术后深静脉血栓形成发生率,记录两组患者术后失血量情况,记录两组患者术后第10天血红蛋白(HGB)、血小板计数、凝血酶原时间(PT)、活化凝血酶原时间(APTT)、D-二聚体变化值。结果在术后深静脉血栓形成发生数方面,对照组与观察组患者深静脉血栓形成发生数分别3例、1例,发生率分别10.0%和3.3%,观察组患者深静脉血栓形成发生率明显更低(P<0.05);在术后出血方面,对照组与观察组患者失血总量分别为(808.3±231.6)、(1128.8±237.6)ml,显性失血量分别为(305.4±108.7)、(448.7±119.4)ml,两组患者术后出血情况对比差异显著(P<0.05);两组治疗前HGB、血小板计数、PT、APTT、D-二聚体变化值差异均无统计学意义(P>0.05),但与治疗前相比,两组各项水平均明显改善(P<0.05),且二组比较差异存在统计学意义(P<0.05)。结论针对关节置换术后深静脉血栓形成的预防,应用利伐沙班治疗疗效确切,安全性高,值得在临床上推广应用。Objective To explore the effectiveness and safety of rivaroxaban when used for preventing deep vein thrombosis after joint replacement.Methods Sixty cases of total hip or total knee replacement were selected in our hospital between January-2017 and January 2018.The patients were randomly divided into two groups.The control group was subcutaneously injected with low molecular weight heparin calcium injection 12 hafter operation.The patients in the observation group took rivaroxaban tablets orally 12 h afteroperation.The results of the color Doppler ultrasound examination of lower extremities after operation were analyzed.The incidence of postoperative deep venous thrombosis was analyzed,and the amount of blood loss in the two groups of patients was recorded.The changes of hemoglobin（HGB）,platelet count,prothrombin time（PT）,activated prothrombin time（APTT）and D-Dimer were recorded in the two groups of patients ten days after operation.Results There were 3 cases and 1 case of deep venous thrombosis in the control group and the observation group respectively,so the incidence of deep vein thrombosis was 10%and 3.3%respectively.The incidence of deep venous thrombosis was significantly lower in the observation group（P 〈0.05）.The amount of hemorrhage was（1088.3＋231.6）and（1128.8＋237.6）ml respectively.The dominant bleeding volume was（395.4＋108.7）and（428.7＋119.4）mL respectively.The difference of postoperative bleeding in the two groups was not significant（P 〉0.05）.Before treatment,platelet count,PT,APTT and HGB D-Dimer were not significantly different between the two groups（P 〉0.05）,but after treatment,these values were significantly improved in both groups（P 〈0.05）,and there was statistically significant difference between the two groups（P 〈0.05）.Conclusion Rivaroxaban has proved to be effective and safe for the prevention of deep venous thrombosis after arthroplasty.It is worthy of clinical application.

关 键 词：利伐沙班 关节置换术 深静脉血栓预防 

分 类 号：R965[医药卫生—药理学]