利伐沙班预防髋部周围骨折内固定术后静脉血栓疗程的研究  

Effect of rivaroxaban on preventing venous thrombosis after internal fixation of hip fracture

作　　者：徐敏超 陈明 徐海军 勘武生[1] 郑琼[1] 胡家朗 熊文[1] 郭鑫 段艳丽 Xu Minchao;Chen Ming;Xu Haijun;Kan Wusheng;Zheng Qiong;Hu Jialang;Xiong Wen;Guo Xin;Duan Yanli(Department of Orthopedics,PuAi Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan Fourth Hospital,Hubei 430033,China)

机构地区：[1]武汉市第四医院华中科技大学同济医学院附属普爱医院骨科,430033

出　　处：《山西医药杂志》2020年第13期1640-1643,共4页Shanxi Medical Journal

基　　金：武汉市卫生计生委科研计划资助项目(WX18Z39)。

摘　　要：目的探讨利伐沙班10 d疗程与35 d疗程的预防髋部周围骨折内固定术后静脉血栓疗效差异。方法选取我院自2018年1月至2019年10月髋部周围骨折内固定手术200例,其中男性97例,女性103例,平均年龄(60±8)岁(27~92岁),按照随机数字表法分为口服利伐沙班片10 d疗程的A组和35 d疗程的B组,各100例。术后复查双下肢深静脉彩色多普勒超声及凝血功能、血小板计数、血红蛋白等。2组患者术后10 d和35 d均进行随访。结果2组患者基本情况差异无统计学意义。A组3例、B组2例术后10 d时彩色多普勒超声检查发现小腿肌间静脉血栓,经治疗1周后,血栓消失。手术前后凝血酶原时间、活化部分凝血活酶时间、血小板计数、血红蛋白,术中平均失血量,术后输血量,术后切口引流量2组比较差异均无统计学意义(P>0.05)。2组患者均未出现大出血事件、切口周围组织血肿和切口愈合不良等。结论利伐沙班预防髋部周围骨折内固定术后静脉血栓安全性好、疗效好,10 d疗程和35 d疗程的疗效无明显差异。Objective To investigate the effect of rivaroxaban 10-day course and 35-day course on preventing venous thrombosis after internal fixation of hip fracture.Methods The 200 patients undergoing internal fixation of hip fracture were divided into two groups randomly from January 2018 to October 2019.There are 97 males and 103 females with an average age of(60±8)years(range from 27 to 92 years).For prevention of venous thromboembolism,group A were given rivaroxaban therapy for 10 days,group B were given rivaroxaban for 35 days.Color doppler ultra-sonography,coagulation function,platelet count and hemoglobin were examined after operation in both groups.The two groups of patients were followed up after operation to find the differences of the effects.Results There were no differences between basic items of the two groups.Inter-muscular venous thrombosis of the leg were found in 3 cases of group A and 2 cases of group B one week after operation.After one week of treatment,intermuscular venous throm-bosis of the leg was not found in these patients.The mean prothrombin time,activated partial thromboplastin time,platelet count,hemoglobin level,total blood loss,the amount of transfusion showed no difference(P>0.05)in two groups.There were no postoperative bleeding cases,hematoma and poor wound healing in both group A and group B.Conclusion Rivaroxaban used for prevention of venous thrombosis after internal fixation of hip fracture was safe and effective.There were no differences between 10-day and 35-day course.

关 键 词：利伐沙班 髋骨折 静脉血栓栓塞 治疗结果 预防 

分 类 号：R687.3[医药卫生—骨科学]