利伐沙班与低分子肝素钙预防髋关节置换术后深静脉血栓形成的疗效分析

目的观察利伐沙班与低分子肝素钙预防髋关节置换术后深静脉血栓(DVT)形成的临床疗效。方法将2011年1月至2013年1月梅河口市中心医院收治的57例行髋关节置换术后的患者采用随机数字表法分为两组:肝素组(25例)采用低分子肝素钙抗凝治疗,利伐沙班组(32例)采用利伐沙班抗凝治疗,比较两组患者DVT、非致死性肺栓塞的发生例数,并记录血红蛋白和血小板计数变化情况。结果两组患者均未见非致死性肺栓塞,肝素组DVT和牙龈出血的发生率均高于利伐沙班组,差异有统计学意义(P<0.05);两组患者术前血红蛋白均较高,用药7 d后均下降,用药14d时又上升(P<0.05),两组患者血小板计数用药7 d均上升,用药14 d时又下降(P<0.05)。结论伐沙班在预防DVT方面有显著的临床疗效,适合于人工髋关节置换的患者,值得临床推广应用。

Analysis on the Therapeutic Effect of Rivaroxahan and Low Molecular Weight Heparin in the Prevention of Hip Replacement Surgery Treatment of Deep Vein Thrombosis

Objective To observe the chnical efficacy of rivaroxaban and low molecular weight heparin in the prevention of deep vein thrombosis （DVT） after hip replacement surgery. Methods A total of 57 patients who had hip replacement surgery at Meihekoushi Central Hospital from Jan. 2011 to Jan. 2013 were included,and were divided into two groups with random number table method, 25 patients of the heparin group used low molecular weight heparin anticoagulant therapy,32 cases of the rivaroxaban group used rivaroxaban anticoagulation therapy. DVT, number of cases of non-fatal pulmonary embolism occurrenceof the two groups were compared,and changes in hemoglobin and platelet counts were recorded. Results There were no non-fatal pulmonary embolism in either group, DVT and gingival bleeding rate of heparin group was higher than the rivaroxaban group,with statistically significant difference （ P 〈 0.05 ） ; the preoperative hemoglobin of both groups were high,which dropped after 7 d of treatment but bounced back after 14 d of treatment（P 〈 0.05 ）, platelet count of both groups increased after 7 d of medication and declined after 14 d of medication （P 〈 0.05 ）. Conclusion Rivaroxaban has significant efficacy in the prevention of DVT, suitable for pa- tients with total hip replacement,thus is worthy of clinical application.