摘要
目的比较利伐沙班与低分子肝素对膝关节术后患者下肢深静脉血栓(DVT)的预防效果。方法收集2019年5月至2021年7月北京航天总医院收治的125例膝关节术后患者临床资料。按照术后治疗方式不同将患者分为利伐沙班组(n=60)和低分子肝素组(n=65)。通过彩色多普勒超声检查确认下肢DVT的发生情况,比较两组患者治疗1周后的治疗总有效率。比较两组患者治疗1周后术后切口引流量、术中输血量、血红蛋白水平,术前、术后3 d、术后7 d的血小板计数以及手术前后的凝血功能指标[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、D-二聚体(D-D)]。比较两组患者术后至出院期间下肢DVT的发生情况。结果利伐沙班组患者的治疗总有效率高于低分子肝素组患者(P<0.05)。两组患者术后切口引流量、术中输血量和血红蛋白水平比较,差异均无统计学意义(P>0.05)。两组患者术前、术后3 d、术后7 d的血小板计数比较,差异均无统计学意义(P>0.05)。术后,两组患者的APTT、PT、D-D水平比较,差异均无统计学意义(P>0.05)。术后至出院期间,利伐沙班组患者下肢DVT的发生率低于低分子肝素组患者,但差异无统计学意义(P>0.05)。结论与低分子肝素相比,利伐沙班对膝关节术后患者下肢DVT形成的预防效果更佳,凝血功能几乎不受影响,值得临床推广。
Objective To compare the effect of Rivaroxaban and low molecular weight heparin(LMWH)in preventing low extremity deep vein thrombosis(DVT)after knee joint surgery.Method Clinical data of 125 patients after knee joint surgery admitted to Beijing Aerospace General Hospital from May 2019 to July 2021 were collected.Patients were divided into Rivaroxaban group(n=60)and LMWH group(n=65)according to different postoperative treatment.The incidence of low extremity DVT was confirmed by color Doppler ultrasonography,and the total effective rate of the two groups after 1 week of treatment was evaluated and compared.After 1 week of treatment,the postoperative incision drainage volume,intraoperative blood transfusion volume and hemoglobin level of the two groups were compared.Platelet count before and 3 and 7 days after surgery and coagulation function indexes[activated partial thromboplastin time(APTT),prothrombin time(PT),D-dimer(D-D)]before and after surgery of the two groups were compared.The incidence of DVT in lower extremity from post-operation to discharge was compared.Result The total effective rate of Rivaroxaban group was higher than that of LMWH group(P<0.05).There were no significant differences in postoperative incision drainage volume,intraoperative blood transfusion volume and hemoglobin level between the two groups(P>0.05).There was no significant difference in PLT count before and 3 and 7 days after surgery(P>0.05).After surgery,there were no significant differences in APTT,PT and D-D level between the two groups(P>0.05).From post-operation to discharge,the incidence of low extremity DVT in Rivaroxaban group was lower than that in LMWH group,but the difference was not statistically significant(P>0.05).Conclusion Rivaroxaban is more effective than low molecular weight heparin in in preventing low extremity DVT after knee joint surgery,and coagulation function is almost not affected,which is worthy of clinical promotion.
作者
刘超
李新宇
杜宇
Liu Chao;Li Xinyu;Du Yu(Department of Pharmacy,Beijing Aerospace General Hospital,Beiijng 100000,China;Department of Vascular Surgery,Beijing Aerospace General Hospital,Beiijng 100000,China)
出处
《血管与腔内血管外科杂志》
2022年第5期591-595,共5页
Journal of Vascular and Endovascular Surgery
关键词
利伐沙班
低分子肝素
膝关节
深静脉血栓
预防效果
Rivaroxaban
low molecular weight heparin
knee joint
deep vein thrombosis
preventive effect
