利伐沙班药物预防HAPC患者全髋、膝关节置换术后深静脉血栓形成的疗效观察  

Therapeutic effect of rivaroxaban on the prevention of deep vein thrombosis after total hip and knee joint replacement in patients with HAPC

作　　者：严文琪[1] 王凯[1] 马显志[1] 韩生寿[1] 白文斌[1] 李玮 YAN Wenqi;WANG Kai;MA Xianzhi;HAN Shengshou;BAI Wenbin;LI Wei(Department of Orthopedics,Qinghai Provincial People’s Hospital,Xi’ning 810007,China)

机构地区：[1]青海省人民医院骨科

出　　处：《中国骨质疏松杂志》2020年第2期294-297,共4页Chinese Journal of Osteoporosis

基　　金：2018年青海省卫生计生委科研课题计划(2018-wjzdx-27)

摘　　要：目的探究利伐沙班运用于高原红细胞增多症(high altitude polycythemia,HAPC)患者全髋、膝关节置换术后深静脉血栓中的预防价值。方法以青海省人民医院2016年2月至2018年2月收治的80例HAPC患者全髋、膝关节置换术后资料为研究对象,遵照院号尾数单双号分成A组(利伐沙班治疗)与B组(低分子肝素钙治疗)各40例。探讨实施不同药物预防对预防效果的影响。结果在深静脉血栓发生率上两组相比,A组(2. 50%)显著比B组(15. 00%)低(P<0. 05);在术后14 d的髂外静脉的平均血流速度上,A组显著比B组高(P<0. 05);A组治疗后的PLT、PT、APTT与B组比较无差异(P>0. 05),A组治疗后的FIB低于B组(P<0. 05)。结论将利伐沙班应用于HAPC患者全髋、膝关节置换术后患者时,可显著改善髂外静脉的平均血流速度及凝血指标,预防深静脉血栓产生。Objective To study the effect of rivaroxaban in the prevention of deep venous thrombosis(DVT) after total hip or knee replacement in patients with high altitude polycythemia(HAPC). Methods 80 high altitude polycythemia(HAPC) patients treated from February 2016 to February 2018 in our hospital were selected and assigned to observation group(n = 40) and control group(n =40) according to odd or even admission number. The observation group was treated with rivaroxaban;the control group was treated with low molecular weight heparin. The therapeutic effect was evaluated. Results The incidence rate of DVT in the observation group(2. 50%) was significantly lower than that in the control group(15. 00%)(P<0. 05). After 14 d of surgery,the mean blood flow velocity of external iliac vein in the observation group was significantly higher than that in the control group(P < 0. 05). After treatment,the values of PLT(platelet count),PT(prothrombin time) and APTT(activated partial thromboplastin time) between the two groups were not significantly different(P>0. 05). After surgery,FIB(fibrinogen) levels in the observation group were lower than those in the control group(P< 0. 05). Conclusion Rivaroxaban could greatly improve the mean blood flow velocity and coagulation indicators in the external iliac vein,and reduce the incidence rate of DVT in HAPC patients after total hip and knee joint replacement.

关 键 词：利伐沙班 深静脉血栓 高原红细胞增多症 全髋、膝关节置换术 

分 类 号：R687.4[医药卫生—骨科学]