[1]张 晨,宋国瑞,刘子歌,等.低分子肝素与利伐沙班预防全膝关节置换术后静脉血栓成形的疗效及安全性对比分析*[J].陕西医学杂志,2020,49(9):1153-1156.[doi:DOI:10.3969/j.issn.1000-7377.2020.09.025]
　ZHANG Chen,SONG Guorui,LIU Zige,et al.Comparative analysis of the efficacy and safety of low molecular weight heparin and rivaroxaban in prevention of venous thrombosis after TKA[J].,2020,49(9):1153-1156.[doi:DOI:10.3969/j.issn.1000-7377.2020.09.025]
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低分子肝素与利伐沙班预防全膝关节置换术后静脉血栓成形的疗效及安全性对比分析*
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
49
期数:
2020年9期
页码:
1153-1156
栏目:
药物与临床
出版日期:
2020-09-01

文章信息/Info

Title:
Comparative analysis of the efficacy and safety of low molecular weight heparin and rivaroxaban in prevention of venous thrombosis after TKA
作者:
张 晨1; 宋国瑞1; 刘子歌1; 王 强1; 郭高鹏1; 程萌旗2; 陈德胜3△
1.宁夏医科大学临床医学院(银川 750004); 2.上海交通大学附属第六人民医院关节外科(上海 200011); 3.宁夏医科大学总医院骨科(银川 750004)
Author(s):
ZHANG Chen; SONG Guorui; LIU Zige; et al.
School of Clinical Medicine,Ningxia Medical University(Yinchuan 750004)
关键词:
人工全膝关节置换术;  利伐沙班;  低分子肝素;  皮下瘀斑;  深静脉血栓;  术后抗凝
Keywords:
Total knee arthroplasty;  Rivaroxaban;  Low molecular weight heparin;  Subcutaneous ecchymosis;  Deep vein thrombosis;  Postoperative anticoagulation
分类号:
R687.4
DOI:
DOI:10.3969/j.issn.1000-7377.2020.09.025
文献标志码:
A
摘要:
目的:对比分析人工全膝关节置换术(TKA)后应用低分子肝素和利伐沙班预防下肢静脉血栓的疗效,并对两种药物出现的并发症进行用药的安全性分析。方法:选择行初次单侧全膝关节置换术患者86例,随机等分为低分子肝素组(43例)和利伐沙班组(43例)。两组术后分别给于低分子肝素、利伐沙班治疗。记录两组术前及术后血小板计数(PLC)、凝血酶原时间(PT)、部分凝血活酶时间(APTT)情况并进行对比。记录两组切口愈合情况、术后引流量及双下肢深静脉、肌间静脉血栓形成、术后皮下瘀斑形成情况并进行对比。结果:所有患者术后切口均一期愈合,两组术前及术后PLC、PT、APTT,以及术后引流量、术后肌间静脉血栓形成比较均无统计学差异(P>0.05); 低分子肝素组深静脉血栓6例,利伐沙班组深静脉血栓1例,两组间比较有统计学差异(P<0.05); 两组出现皮下瘀斑例数(低分子肝素组18例,利伐沙班组11例)比较有统计学差异(P<0.05),最大瘀斑面积[低分子肝素组(2.96±1.21)%,利伐沙班组(1.64±0.68)%]比较差异有统计学意义(P<0.05)。结论:与低分子肝素相比,在TKA术后足疗程应用利伐沙班可更有效地预防下肢静脉血栓形成,且安全性更高。
Abstract:
Objective:To compare and analyze the efficacy of low molecular weight heparin and rivaroxaban in preventing lower extremity venous thrombosis after total knee arthroplasty(TKA),and to analyze the safety of medication for the complications of the two drugs.Methods:A total of 86 patients who underwent the first unilateral TKA were selected and randomly divided into low-molecular-weight heparin group(43 cases)and rivaroxaban group(43 cases),and the two groups were respectively treated with low-molecular-weight heparin and rivaroxaban after surgery.Preoperative and postoperative platelet counts(PLC),prothrombin time(PT),and partial thromboplastin time(APTT)were recorded and compared between two groups.Incision healing,postoperative drainage,and thrombosis of deep lower limbs and intermuscular veins,and the formation of subcutaneous ecchymosis were recorded and compared between two groups too.Results:All patients had incision healing in stage Ⅰ.There was no significant difference in PLC,PT,APTT before and after operation between the two groups and no significant difference in postoperative drainage and intramuscular venous thrombosis between the two groups(P>0.05).There were 6 cases of deep vein thrombosis in low-molecular-weight heparin group and 1 case of deep vein thrombosis in rivaroxaban group,with statistical difference between the two groups(P<0.05).There was significant difference between the two groups in the number of cases of subcutaneous ecchymosis(18 cases in low-molecular-weight heparin group and 11 cases in rivaroxaban group)(P<0.05),and the largest ecchymosis area [(2.96±1.21)% in low-molecular-weight heparin group and(1.64±0.68)% in rivaroxaban group] were significantly different(P<0.05).Conclusion:Compared with low-molecular-weight heparin,rivaroxaban can effectively prevent venous thrombosis of the lower limbs and has more safety after TKA.

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备注/Memo

备注/Memo:
*国家自然科学基金资助项目(81760405,81760395,81560364)；宁夏回族自治区自然科学基金资助重点项目(2018AAC02013)；宁夏医科大学校级科研重点项目(XZ2018014)
更新日期/Last Update: 2020-09-02