阿司匹林在TKA术后预防静脉血栓栓塞中作用的研究  

Study on the Role of Aspirin in Preventing Venous Thromboembolism after TKA

作　　者：刘丹 潘宏[1] LIU Dan;PAN Hong(Department of Orthopedics,Anqing Municipal Hospital,Anhui Medical University,Anqing,Anhui Province,246000 China)

机构地区：[1]安徽医科大学附属安庆市立医院骨科,安徽安庆246000

出　　处：《中外医疗》2022年第3期129-132,共4页China & Foreign Medical Treatment

摘　　要：目的通过比较在膝关节置换(TKA)术后分别运用阿司匹林、低分子肝素及利伐沙班预防静脉血栓栓塞,从而评价阿司匹林的临床疗效。方法随机选取2020年1月—2021年6月该院接收的因膝关节骨性关节炎行TKA术的患者90例,随机将所有患者分为阿司匹林组(n=24),低分子肝素组(n=40),利伐沙班组(n=26),分别比较3组患者术前及术后凝血功能(PT,APTT)、纤维蛋白降解物(FDP)、纤维蛋白、白介素-1(IL-1)、白介素-6(IL-6)、D-二聚体、彩超下肢血栓形成情况。结果3组患者D-二聚体、FDP、纤维蛋白、IL-1和IL-6围术期数据随访最后一次减去第一次的值比较,差异无统计学意义(H=1.777、0.882、2.285、2.339、0.089,P>0.05);3组患者PT、APTT围术期数据随访最后一次减去第一次的值比较,差异无统计学意义(F=0.621、1.288,P>0.05);3组患者彩超结果中,阿司匹林组正常12例,异常12例,利伐沙班组正常16例,异常10例,低分子肝素组正常16例,异常24例,3组比较,差异无统计学意义(χ^(2)=2.942,P=0.230)。结论阿司匹林在TKA术后预防静脉血栓栓塞的过程中,疗效与低分子肝素及利伐沙班相差不大。Objective By comparing the use of aspirin,low-molecular-weight heparin and rivaroxaban to prevent venous thromboembolism after total knee arthroplasty(TKA),the clinical efficacy of aspirin was evaluated.Methods From January 2020 to June 2021,90 patients receiving TKA for knee osteoarthritis in the hospital were conveniently selected.All patients were randomly divided into aspirin group(n=24),LMWH group(n=40),and rivaroxaban group(n=26).Preoperative and postoperative coagulation function(PT,APTT),fibrin degradator(FDP),fibrin,interleukin-1(IL-1),interleukin-6(IL-6),D-dimer and color ultrasound thrombosis of lower limbs were compared between three groups of patients.Results There was no statistically significant difference in the perioperative data of D-dimer,FDP,fibrin,IL-1 and IL-6 among the three groups of patients after the last follow-up minus the first time(H=1.777,0.882,2.285,2.339,0.089,P>0.05);there was no statistically significant difference in the perioperative data of PT and APTT in the three groups after the last follow-up minus the first time(F=0.621,1.288,P>0.05).In the color Doppler ultrasound results of the three groups of patients,12 were normal and 12 were abnormal in the aspirin group,16 were normal and 10 were abnormal in the rivaroxaban group,and 16 were normal and 24 were abnormal in the low-molecular-weight heparin group,there was no significant difference among the three groups(χ^(2)=2.942,P=0.230).Conclusion In the process of preventing venous thromboembolism after TKA,aspirin has the same effect as low molecular weight heparin and rivaroxaban.

关 键 词：阿司匹林 深静脉血栓 膝关节置换术 白介素-6 

分 类 号：R4[医药卫生—临床医学]