利伐沙班与低分子肝素预防膝关节翻修术后深静脉血栓的临床疗效分析

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利伐沙班与低分子肝素预防膝关节翻修术后深静脉血栓的临床疗效分析

郑和祝,赵海燕

岑巩县人民医院,兰州大学第二医院

收稿日期:2018-01-02 修回日期:2018-02-05 出版日期:2018-02-25 发布日期:2018-01-25

Analysis of clinical effect between rivaroxaban and low molecular weight heparin in prevention of deep vein thrombosis in revision total knee athroplasty

zheng he zhu and 赵海燕

Department of orthopedics, cengong people’s hospital,

Received:2018-01-02 Revised:2018-02-05 Online:2018-02-25 Published:2018-01-25

摘要/Abstract

摘要： 目的:比较利伐沙班与低分子肝素预防膝关节翻修术后深静脉血栓（Deep Vein Thrombosis，DVT）的临床疗效。方法:回顾分析2014年1月—2017年1月收治的58例（59膝）膝关节翻修患者的临床资料，按 DVT预防方式分为低分子肝素组33例（33膝）和利伐沙班组25例（26膝），采用SPSS19.0统计软件进行分析，比较两组患者术后DVT及出血事件的发生率和膝关节疼痛、肿胀、淤血瘀斑、功能以及不良事件发生率的差异。结果:术后患者切口均Ⅰ期愈合，利伐沙班组和低分子肝素组DVT的发生率为分别为4.00%（1/25）和6.06%（2/33），两组差异无统计学意义（P＞0.05）。利伐沙班组皮下瘀斑的发生率为36.00%（9/25），显著高于低分子肝素组6.06%（2/33），差异有统计学意义（P＜0.05）。两组患者术后引流量、出凝血指标、肢体肿胀程度及膝关节HSS（Hospital for Special surgery knee Score）评分、VAS（Visual Analogue Score）疼痛评分、不良事件的发生率均无统计学差异（P＞0.05）。结论:利伐沙班和低分子肝素预防膝关节翻修术后DVT安全有效，二者效果相当，但利伐沙班增加了皮下瘀斑形成的风险。

Abstract: Objective:To compare the clinical effect between rivaroxaban and low molecular weight heparin (LMWH) in prevention of deep vein thrombosis (DVT) in revision total knee athroplasty(TKA). Method:between January 2014 and January 2017,58 patients (59 knees) underwent revision TKA, the clinical data were analyzed. The patients were divided into rivaroxaban group (26 cases) and LMWH group (33 cases) according to different DVT prevention. The incidences of DVT, bleeding and the swelling, bruising and function of knee as well as adverse event rate were compared between the two groups. Result: Healing of incisions by first intention was achieved, after one-month follow-up, DVT incidence in rivaroxaban group was 4.00%(1/25) and LMWH was 6.06%(2/33),there was no statistical difference between these groups (P＞0.05). Subcutaneous ecchymosis in LMWH group (6.06%, 2/33)was significantly lower than that in rivaroxaban (36.00%, 9/25, P＜0.05), and there was no statistical difference in bleeding, unexpected event, volume of drainage, blood coagulation index, limb swelling degree, HSS score and VAS score between these two groups (P＞0.05). Conclusion: Both rivaroxaban and LMWH can effectively prevent DVT without the added risk of bleeding after revision TKA, rivaroxaban can increased the risk of subcutaneous ecchymosis.

郑和祝,赵海燕. 利伐沙班与低分子肝素预防膝关节翻修术后深静脉血栓的临床疗效分析[J]. .

zheng he zhu and 赵海燕. Analysis of clinical effect between rivaroxaban and low molecular weight heparin in prevention of deep vein thrombosis in revision total knee athroplasty[J]. .

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