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[1]易春智,陳錦倫,李肇宏,等.利伐沙班與依諾肝素鈉對髖膝關(guān)節(jié)置換術(shù)后 下肢深靜脈血栓形成及圍手術(shù)期隱性失血的影響[J].中醫(yī)正骨,2016,28(01):17-19.
　YI Chunzhi,CHEN Jinlun,LI Zhaohong,et al.Influence of Rivaroxaban and enoxaparin sodium on lower extremity deep venous thrombosis after total hip&knee arthroplasty and perioperative hidden blood loss[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(01):17-19.
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利伐沙班與依諾肝素鈉對髖膝關(guān)節(jié)置換術(shù)后 下肢深靜脈血栓形成及圍手術(shù)期隱性失血的影響()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期數(shù):
2016年01期
頁碼:
17-19
欄目:
臨床研究
出版日期:
2016-01-20

文章信息/Info

Title:
Influence of Rivaroxaban and enoxaparin sodium on lower extremity deep venous thrombosis after total hip&knee arthroplasty and perioperative hidden blood loss
作者:
易春智1; 陳錦倫2; 李肇宏2; 曾建春1; 樊粵光1
1.廣州中醫(yī)藥大學(xué)第一附屬醫(yī)院,廣東 廣州 510405;
2.廣州中醫(yī)藥大學(xué),廣東 廣州 510006
Author(s):
YI Chunzhi1; CHEN Jinlun2; LI Zhaohong2; ZENG Jianchun1; FAN Yueguang1
1.The First Affiliated Hospital of Guangzhou University of traditional Chinese medicine,Guangzhou 510405,Guangdong,China 2.Guangzhou University of traditional Chinese medicine,Guangzhou 510006,Guangdong,China
關(guān)鍵詞:
關(guān)節(jié)成形術(shù); 置換; 髖;  關(guān)節(jié)成形術(shù); 置換; 膝;  抗凝藥;  手術(shù)后并發(fā)癥;  靜脈血栓形成;  失血; 手術(shù)
Keywords:
arthroplasty; replacement; hip;  arthroplasty; replacement; knee;  anticoagulants;  postoperative complications;  venous thrombosis;  blood loss; surgical
摘要:
目的:比較利伐沙班與伊諾肝素鈉對髖、膝關(guān)節(jié)置換術(shù)后下肢深靜脈血栓形成及圍手術(shù)期隱性失血的影響。方法:初次接受髖、膝關(guān)節(jié)置換手術(shù)的患者102例,男42例、女60例; 年齡24～79歲,中位數(shù)55歲; 全髖置換72例80髖,全膝置換30例33膝。隨機(jī)分為2組,利伐沙班組54例,術(shù)后口服利伐沙班片抗凝; 依諾肝素鈉組48例,術(shù)后皮下注射依諾肝素鈉抗凝。觀察2組患者術(shù)后下肢深靜脈血栓形成及不良反應(yīng)發(fā)生情況,記錄2組患者失血量并進(jìn)行比較。結(jié)果:術(shù)后第5天,2組患者實際失血總量、顯性失血量、隱性失血量比較,組間差異均無統(tǒng)計學(xué)意義[(1433.02±565.31)mL,(1405.13±575.28)mL; t=0.246,P=0.805;(615.28±291.99)mL,(509.28±308.35)mL; t=1.782,P=0.078;(817.74±435.82)mL,(895.85±468.64)mL; t=0.872,P=0.385]。102例患者切口均甲級愈合,均無下肢深靜脈血栓形成發(fā)生,未出現(xiàn)消化道出血等不良反應(yīng)。結(jié)論:利伐沙班和依諾肝素鈉用于初次髖、膝關(guān)節(jié)置換患者的術(shù)后抗凝治療,均可有效預(yù)防下肢深靜脈血栓形成的發(fā)生,安全性好,兩者對圍手術(shù)期隱性失血的影響相當(dāng)。
Abstract:
Objective:To compare the influence of Rivaroxaban and enoxaparin sodium on lower extremity deep venous thrombosis(DVT)after total hip&knee arthroplasty(THA&TKA)and perioperative hidden blood loss.Methods:One hundred and two patients(42 males and 60 females)between the ages of 24 and 79 years(Median=55 yrs)were recruited.Seventy two patients received THA in 80 hips and 30 patients received TKA in 33 knees.The patients were randomly divided into 2 groups,54 cases in Rivaroxaban group and 48 cases in enoxaparin sodium group.The patients in Rivaroxaban group were treated with oral application of Rivaroxaban after the surgery for anticoagulation,while the patients in enoxaparin sodium group were treated with hypodermic injection of enoxaparin sodium for anticoagulation.The lower extremity DVT and adverse reactions were observed and compared between the 2 groups after the surgery,and the blood loss were recorded and compared between the 2 groups.Results:There was no statistical difference in the actual total blood loss,dominant blood loss and hidden blood loss between the 2 groups at the 5th day after surgery(1433.02+/-565.31 vs 1405.13+/-575.28 ml,t=0.246,P=0.805; 615.28+/-291.99 vs 509.28+/-308.35 ml; t=1.782,P=0.078; 817.74+/-435.82 vs 895.85+/-468.64 ml; t=0.872,P=0.385). All of the patients in the 2 groups got primary healing in the operative incisions and no lower extremity DVT and adverse reactions such as gastrointestinal bleeding were found.Conclusion:Both Rivaroxaban and enoxaparin sodium can be used as postoperative anticoagulants in patients who receive THA or TKA for they can effectively prevent lower extremity DVT with high safety,and they have similar effects on the perioperative hidden blood loss.

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通訊作者:陳錦倫 E-mail:[email protected]
更新日期/Last Update: 2016-02-29