老年髋部骨折术后利伐沙班抗凝干预时间对患者出血风险的影响

目的：探讨老年髋部骨折术后利伐沙班抗凝干预时间对患者出血风险的影响。方法：选取2013年5月～2014年12月于我院就诊的老年髋部骨折患者86例为研究对象，采用随机数字表法分为观察组和对照组各43例，对照组术后2周内连服利伐沙班，观察组服用利伐沙班1周时改用安慰剂，记录两组实际总失血量、隐失血量、隐性失血量占实际总失血量百分比，干预后1个月观察两组出血事件发生率及不良反应发生情况。结果：观察组实际总失血量（1.24±0.28）L、隐性失血量（0.33±0.14）L与对照组比较明显较低（P＜0.05）；观察组隐性失血量占实际总失血量百分比（40.57±0.98）%明显低于对照组（P＜0.05）；两组出血事件发生率比较无显著差异（P﹥0.05）。结论：利伐沙班使用时间对老年髋部骨折术后出血有一定影响，存在隐性出血风险，临床需予以重视。

Effects of postoperative rivaroxaban anticoagulation intervention time on risk of hemorrhage of elderly patients with hip fracture

Objective:To explore effects of postoperative rivaroxaban anticoagulation intervention time on risk of hemorrhage of elderly patients with hip fracture. Methods:86 cases of hip fracture treated in our hospital from May 2013 to December 2014 were selected as research objects, they were divided by random number table into the observation group and the control group (each 43 cases), the control group was given rivaroxaban within two weeks after the operation, the observation group was given rivaroxaban one week, then switched to a placebo, the two groups were given treatment for 2 weeks, actual total blood loss, dominant blood loss, hidden blood loss, percentage of hidden blood of actual total blood loss of the two groups within 2 weeks were recorded, the rate of bleeding event, adverse reaction of the two groups one month after the intervention were observed. Results:There was no significant difference in the dominant blood loss (0.33±0.14) L,(0.32±0.13) L] between the two groups(P﹥0.05), but actual total blood loss (0.54±0.18)L, hidden blood loss(0.21±0.04)L of the observation group were significantly lower than the control group(P<0.05), percentage of hidden blood of actual total blood loss of the observation group(40.57±0.98)% were significantly lower than the control group(P<0.05); there was no significant difference in the rate of bleeding event between the two groups(P﹥0.05). Conclusion:Using time of rivaroxaban has a certain effect on postoperative hemorrhage of elderly patients with hip fracture, there is a risk of hidden blood loss, it should be paid more attention in clinical practice.