标题：髋关节置换后应用利伐沙班预防深静脉血栓的疗效及安全性分析

      作者：丁 洪 1，何应英 2，陈 彦 1
    (1.重庆市北部新区第一人民医院骨科，重庆 411020；
2.重庆市九龙坡区第二人民医院，重庆 400052)

      卷次： 2014年25卷13期

      【摘要】 目的 观察利伐沙班预防髋关节置换后深静脉血栓的疗效及安全性。方法 选取120例髋关节置
换术患者采用信封法随机分为低分子肝素组与利伐沙班组各60例，手术前后及用药后采用彩色多普勒检查，评
估双下肢深静脉血栓(DVT)形成情况，仔细记录引流量。用药期间密切监测患者肝肾功能及血、尿常规，观察患
者有无出血，并定期监测凝血指标。结果 低分子肝素组6例(10.00%)发生DVT，利伐沙班组5例(8.33%)发生
DVT，两组患者DVT发生率比较差异无统计学意义(P>0.05)。利伐沙班术后引流量为(95.8±6.1) ml，低分子肝素
组引流量为(94.5±6.5) ml，两组患者引流量差异也无统计学意义(P>0.05)。两组患者术后的活化部分凝血活酶时
间(APTT)、凝血酶原时间(PT)及血小板(PLT)比较差异均无统计学意义(P>0.05)，且两组患者均无肺栓塞及出血
不良反应。结论 利伐沙班在预防全髋置换后下肢深静脉血栓的疗效与安全性方面与低分子肝素作用相当，但
是其用药方便，避免低分子肝素皮下注射引起的血肿，患者依从性更好。

      【关键词】 利伐沙班；低分子肝素；髋关节置换；下肢深静脉血栓；安全性

      【中图分类号】 R687.4 【文献标识码】 A 【文章编号】 1003—6350（2014）13—1916—03


Efficacy and safety of applying rivaroxaban to prevent deep venous thrombosis in patients underwent hip
arthroplasty.
DING Hong 1, HE Ying-ying 2, CHEN Yan 1. 1. Department of Orthopedics, the First People's Hospital of
Northern New District of Chongqing, Chongqing 411020, CHINA; 2. The Second People's Hospital of Jiulongpo District of
Chongqing, Chongqing 400052, CHINA

【Abstract】 Objective To explore the efficiency and safety of applying rivaroxaban to prevent deep venous
thrombosis in patients underwent hip arthroplasty. Methods One hundred and twenty cases of patients underwent hip
arthroplasty were randomly divided into two groups, research group (60 cases treated with rivaroxaban) and control
group (60 cases treated with LMWH). Color doppler examination was carried out to evaluate the formation of DVT in
both lower limbs before and after the surgery and after the medication. The volume of drainage was also recorded. The
hepatic and renal function, blood routine and urine routine were detected during the medication. Besides, bleeding of pa-
tients was observed and coagulation indicators were detected regularly. Results In LMWH group, there were 6 cases of
DVT (10.00%), while in rivaroxaban group there were 5 cases of DVT (8.33%). There was no significant difference in
the incidence of DVT between the two groups (P>0.05). The postoperative volume of drainage in rivaroxaban group was
(95.8±6.1) ml, while in LMWH group it was (94.5±6.5) ml. Moreover, there was no significant difference in the volume
of drainage, APTT, PT and PLT between the two groups (P>0.05). No adverse events, such as bleeding or pulmonary em-
bolism, were found in both groups. Conclusion Rivaroxaban had the same efficacy and safety in the prevention of deep
vein thrombosis in patients after total hip arthroplasty as low molecular weight heparin. Furthermore, it can avoid hemato-
ma caused by subcutaneous injection of low molecular weight heparin and is easier to be used with better compliance.

      【Key words】 Rivaroxaban; Low molecular weight heparin; Hip arthroplasty; Deep vein thrombosis; Security
·论 著·