[1]易春智,陈锦伦,李肇宏,等.利伐沙班与依诺肝素钠对髋膝关节置换术后 下肢深静脉血栓形成及围手术期隐性失血的影响[J].中医正骨,2016,28(01):17-19.
　YI Chunzhi,CHEN Jinlun,LI Zhaohong,et al.Influence of Rivaroxaban and enoxaparin sodium on lower extremity deep venous thrombosis after total hip&knee arthroplasty and perioperative hidden blood loss[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(01):17-19.
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利伐沙班与依诺肝素钠对髋膝关节置换术后 下肢深静脉血栓形成及围手术期隐性失血的影响()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期数:
2016年01期
页码:
17-19
栏目:
临床研究
出版日期:
2016-01-20

文章信息/Info

Title:
Influence of Rivaroxaban and enoxaparin sodium on lower extremity deep venous thrombosis after total hip&knee arthroplasty and perioperative hidden blood loss
作者:
易春智1; 陈锦伦2; 李肇宏2; 曾建春1; 樊粤光1
1.广州中医药大学第一附属医院,广东 广州 510405;
2.广州中医药大学,广东 广州 510006
Author(s):
YI Chunzhi1; CHEN Jinlun2; LI Zhaohong2; ZENG Jianchun1; FAN Yueguang1
1.The First Affiliated Hospital of Guangzhou University of traditional Chinese medicine,Guangzhou 510405,Guangdong,China 2.Guangzhou University of traditional Chinese medicine,Guangzhou 510006,Guangdong,China
关键词:
关节成形术; 置换; 髋;  关节成形术; 置换; 膝;  抗凝药;  手术后并发症;  静脉血栓形成;  失血; 手术
Keywords:
arthroplasty; replacement; hip;  arthroplasty; replacement; knee;  anticoagulants;  postoperative complications;  venous thrombosis;  blood loss; surgical
摘要:
目的:比较利伐沙班与伊诺肝素钠对髋、膝关节置换术后下肢深静脉血栓形成及围手术期隐性失血的影响。方法:初次接受髋、膝关节置换手术的患者102例,男42例、女60例; 年龄24～79岁,中位数55岁; 全髋置换72例80髋,全膝置换30例33膝。随机分为2组,利伐沙班组54例,术后口服利伐沙班片抗凝; 依诺肝素钠组48例,术后皮下注射依诺肝素钠抗凝。观察2组患者术后下肢深静脉血栓形成及不良反应发生情况,记录2组患者失血量并进行比较。结果:术后第5天,2组患者实际失血总量、显性失血量、隐性失血量比较,组间差异均无统计学意义[(1433.02±565.31)mL,(1405.13±575.28)mL; t=0.246,P=0.805;(615.28±291.99)mL,(509.28±308.35)mL; t=1.782,P=0.078;(817.74±435.82)mL,(895.85±468.64)mL; t=0.872,P=0.385]。102例患者切口均甲级愈合,均无下肢深静脉血栓形成发生,未出现消化道出血等不良反应。结论:利伐沙班和依诺肝素钠用于初次髋、膝关节置换患者的术后抗凝治疗,均可有效预防下肢深静脉血栓形成的发生,安全性好,两者对围手术期隐性失血的影响相当。
Abstract:
Objective:To compare the influence of Rivaroxaban and enoxaparin sodium on lower extremity deep venous thrombosis(DVT)after total hip&knee arthroplasty(THA&TKA)and perioperative hidden blood loss.Methods:One hundred and two patients(42 males and 60 females)between the ages of 24 and 79 years(Median=55 yrs)were recruited.Seventy two patients received THA in 80 hips and 30 patients received TKA in 33 knees.The patients were randomly divided into 2 groups,54 cases in Rivaroxaban group and 48 cases in enoxaparin sodium group.The patients in Rivaroxaban group were treated with oral application of Rivaroxaban after the surgery for anticoagulation,while the patients in enoxaparin sodium group were treated with hypodermic injection of enoxaparin sodium for anticoagulation.The lower extremity DVT and adverse reactions were observed and compared between the 2 groups after the surgery,and the blood loss were recorded and compared between the 2 groups.Results:There was no statistical difference in the actual total blood loss,dominant blood loss and hidden blood loss between the 2 groups at the 5th day after surgery(1433.02+/-565.31 vs 1405.13+/-575.28 ml,t=0.246,P=0.805; 615.28+/-291.99 vs 509.28+/-308.35 ml; t=1.782,P=0.078; 817.74+/-435.82 vs 895.85+/-468.64 ml; t=0.872,P=0.385). All of the patients in the 2 groups got primary healing in the operative incisions and no lower extremity DVT and adverse reactions such as gastrointestinal bleeding were found.Conclusion:Both Rivaroxaban and enoxaparin sodium can be used as postoperative anticoagulants in patients who receive THA or TKA for they can effectively prevent lower extremity DVT with high safety,and they have similar effects on the perioperative hidden blood loss.

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备注/Memo

备注/Memo:
通讯作者:陈锦伦 E-mail:chen_jinlun@126.com
更新日期/Last Update: 2016-02-29