摘要
目的:探讨利伐沙班与低分子肝素对股骨转子间骨折(IFF)患者术后凝血功能及下肢深静脉血栓(DVT)的影响。方法:按照随机数字表法将2021年2月—2023年2月在本院接受治疗的72例IFF患者分为两组,各36例。对照组采用低分子肝素治疗[分别于入院至术前12 h、术后6 h采用低分子肝素钙皮下注射,4 100 IU/次],观察组采用利伐沙班治疗[于入院至术前12 h口服利伐沙班,10 mg/次,1次/d,并于术后2~12 h继续口服用药,10 mg/次,1次/d],两组均持续治疗至出院。比较两组凝血功能、DVT形成率、感染情况、术后康复情况、出血性事件以及不良反应。结果:治疗前两组活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(FIB)和D-二聚体(D-D)水平比较无统计学差异(P>0.05);治疗后两组APTT和PT较治疗前明显增长,FIB水平明显增高,D-D水平明显降低,且观察组均优于对照组(P<0.05)。相比于对照组,观察组DVT形成率较低(P<0.05)。治疗前两组白细胞计数(WBC)、白细胞介素-6(IL-6)、C反应蛋白(CRP)和降钙素原(PCT)水平比较无统计学差异(P>0.05);治疗后两组WBC、IL-6、PCT和IL-6水平较治疗前降低(P<0.05);治疗后,观察组WBC和IL-6与对照组比较无统计学差异(P>0.05),观察组PCT和IL-6水平低于对照组(P<0.05)。两组出血性事件总发生率比较无统计学差异(P>0.05)。两组不良反应总发生率比较无统计学差异(P>0.05)。结论:利伐沙班与低分子肝素在IFF患者术后治疗中效果确切,二者均具有较高的安全性,但利伐沙班的整体疗效优于低分子肝素,在改善患者凝血功能、降低患者感染指标、减少DVT形成率等方面作用更为突出,值得推广。
Objective:To investigate the effects of rivaroxaban and low-molecular-weight heparin on postoperative coagulation function and lower-extremity deep vein thrombosis(DVT) in patients with intertrochanteric fracture(IFF) of the femur.Methods:According to the random number table method,72 patients with IFF who received treatment in our hospital between February 2021 and February 2023 were divided into two groups,with 36 patients in each group.The control group was treated with low molecular weight heparin[subcutaneous injection of low molecular weight heparin calcium 4 100 IU/time from admission to surgery 12 h and 6 h after surgery,respectively)].The observation group was treated with rivaroxaban[oral rivaroxaban 10 mg/time,once a day from admission to surgery for 12 h,and continued oral administration 10 mg/time from2 ~12 h after surgery,1 time/day].Both groups continued the treatment until discharge.Coagulation function,DVT formation rate,infection,postoperative rehabilitation,bleeding events,and adverse reactions were compared between the two groups.Results:There were no statistically significant differences in the activated partial thromboplastin time(APTT),prothrombin time(PT),fibrinogen(FIB),and D-dimer(D-D) levels between the two groups before treatment(P>0.05).After treatment,APTT and PT in both groups increased significantly compared to before treatment,FIB levels increased significantly,D-D levels decreased significantly,and the observation group was better than the control group(P<0.05).Compared with the control group,the observation group had a lower DVT formation rate(P<0.05).There were no statistically significant differences in the white blood cell count(WBC),interleukin-6(IL-6),C-reactive protein(CRP),and procalcitonin(PCT)levels between the two groups before treatment(P>0.05).After treatment,the levels of WBC,IL-6,PCT,and IL-6 in both groups decreased compared with those before treatment(P<0.05).After treatment,there was no statistically significant difference in WBC and IL-6 levels between the observation and control groups(P>0.05),whereas PCT and IL-6 levels in the observation group were lower than those in the control group(P<0.05).There was no statistically significant difference in the total incidence of hemorrhagic events between the two groups(P>0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusions:Rivaroxaban and low-molecular-weight heparin are highly safe and effective in the postoperative treatment of IFF patients.However,the overall efficacy of rivaroxaban was better than that of low-molecular-weight heparin.Its role in improving coagulation function,reducing infection indicators,and decreasing the DVT formation rate is more prominent and worth promoting.
作者
邱剑华
Qiu Jianhua(Second Affiliated Hospital of Jiujiang University,Jiangxi 332005)
出处
《天津药学》
2024年第3期33-36,共4页
Tianjin Pharmacy
关键词
股骨转子间骨折
利伐沙班
低分子肝素
凝血功能
下肢静脉血栓
intertrochanteric fracture of the femur
levaroxaban
low molecular weight heparin
coagulation function
lower limb venous thrombosis
