利伐沙班与低分子肝素对下肢骨折后深静脉血栓的预防效果比较

目的 比较利伐沙班与低分子肝素钠在预防下肢深静脉血栓方面的效果。方法 选取安康市中心医院住院部下肢骨折患者120例，随机分为两组，每组60例，对照组术后24 h给予低分子肝素钠预防，观察组术后24 h给予利伐沙班预防。分别于术后24 h、5 d、10 d检查患者血浆凝血酶-抗凝血酶ⅡI复合物（TAT）值以及检测术后10 d和术前患者体内血小板和血红蛋白值，再结合10 d内发生的出血和下肢深静脉血栓（DVT）事件，评估利伐沙班和低分子肝素钠在预防DVT的效果。结果 两组下肢骨折患者术后24 h、5 d的TAT值明显高于术前（P<0.05），与术后24 h时高水平TAT值相比，利伐沙班在术后5 d可以显著降低血浆TAT值（P<0.05），并且降低水平显著低于低分子肝素钠（P<0.05）。两组患者术后10 d体内血小板和血红蛋白值与术前比较，差异无统计学意义。观察组在给药后至术后10 d的时间里发生出血事件和DVT的概率均明显小于对照组（P<0.05）。结论 与低分子肝素钠相比，采用利伐沙班可较有效影响人体凝血系统，降低下肢深静脉血栓发生率，减小出血事件。

Efficacy comparison on low molecular weight heparin and rivaroxaban in preventing deep vein thrombosis (DVT)

Objective To compare the efficacies bewteen low molecular weight heparin (LMWH) and rivaroxaban in preventing deep vein thrombosis (DVT). Methods Totally 120 patients with fracture of lower limb being in hospital selected and they were devided into two groups, 60 in each group. After 24 h of surgery, the patients in control group were given LMWH and those in observation group were given rivaroxaban. TAT value was tested respectively on 24 h, 5 d, and 10 d after surgery. Blood platelet and hemoglobin were tested respectively on preoperation and 10 d after surgery. Combined with DVT and bleeding events happened in 10 d, the efficacy of preveting DVT was evaluated bewteen LMWH and rivaroxaban. Results The TAT values tested 5 and 10 d after surgery were significantly higher than those of pre-operation (P<0.05). Comparing with the high level TAT value on 24 h after surgery, rivaroxaban could descend TAT value significantly on 5 d after surgery (P<0.05) and the descending degree was significantly lower than that of LMWH (P<0.05). Compared with the blood platelet and hemoglobin between 10 d after surgery and pre-operation, there was no statistical significance. When using rivaroxaban, the probability of preventing DVT and reducing bleeding events was remarkably lower than that of LMWH (P<0.05). Conclusion Compared with LMWH, using rivaroxaban could affect the coagulation system effectively, decrease the probability of DVT, and reduce bleeding events.