利伐沙班预防股骨粗隆间骨折术后DVT的研究

目的评价利伐沙班预防股骨粗隆间骨折内固定术后深静脉血栓（deepvenousthrombosis，DVT）的临床效果。方法对股骨粗隆间骨折内固定术后的患者随机给予低分子肝素钙（对照组）和利伐沙班（实验组）预防DVT。检测术前及术后14d的凝血指标，B超检查评价DVT的发生。观察并记录术后严重器官出血及切口大血肿情况，记录术后24h内切口引流量。结果实验组术后14d的凝血指标与术前比较无统计学差异，术后14d两组之间均无统计学差异。实验组和对照组的DVT发生率分别为10．8％和13．4％，两组间未见统计学差异。两组均未出现严重器官出血及切口大血肿，两组术后24h引流量之间未见明显差异。结论利伐沙班可以有效预防股骨粗隆间骨折内固定术后DVT的发生，不增加出血风险，具有良好的安全性。可以避免长期注射给患者带来的不便与痛苦，具有良好的可行性和依从性。

The Clinical Study of Rivaroxaban in Prevention of Deep Venous Thrombosis after Internal Fixation of Femoral Intertrochanteric Fracture

Objective To evaluate the clinical effect of rivaroxaban in prevention deep venous thrombosis （DVT） after internal fixation of femoral intertrochanteric fracture. Methods After internal fixation of femoral in- tertrochanteric fracture,the patients were randomized to receive low molecular weight heparin （control group） and ri- varoxaban （experimental group） to prevent DVT. The coagulation indexes were examined before and 14 days after surgery. B-ultrasound examination was used to evaluate the incident of DVT. To observe and record the complications of severe postoperative organ bleeding and wound hematoma,and to record the incision drainage within 24 hours after surgery. Results There was no significant difference in coagulation indicators between before and 14 days after surgery in experiment group ,and there was no significant difference in coagulation indicators 14 days after surgery be- tween experiment group and control group. The incidences of DVT in experiment group and control group were 10. 8 %and 13.4 ~/0respectively,and there was no significant difference between the two groups. No serious organ bleeding and wound hematoma were observed in both groups ,and there was no significant difference in incision drainage within 24 hours after surgery hetween the two groups. Conclusion Rivaroxaban can be effective in preventing DVT after in- ternal fixation of femoral intertrochanteric fracture and does not increase the potential risk of bleeding with good secu- rity for administration. It can also decrease the inconvenience and pain of patients with long-term injection with a good feasibility and compliance.