髋关节置换术后利伐沙班预防下肢深静脉血栓的疗效与安全性

库尔班·艾克木

[摘要] 目的 探討髋关节置换术后利伐沙班预防下肢深静脉血栓的疗效与安全性。 方法 方便选取2012年2月—2015年5月该院收治的髋关节置换术患者150例，按照入院编号奇偶数分为两组各75例，研究组口服利伐沙班，对照组皮下注射低分子肝素注射液，对比两组患者治疗效果及不良反应。 结果 血小板数（PLT）检验值为（100～300）×109/L；活化部分凝血活酶时间（APTT）检验值为32～43 s，延后10 s为异常；血浆凝血酶原时间（PT）检验值为11-15s。研究组患者PLT（×109/L）治疗前（213.7±43.1），治疗后（193.2±27.8）；APTT治疗前（24.9±5.7）s，治疗后（31.6±5.9）s；PT治疗前（11.5±2.8）s，治疗后（12.4±2.6）s；对照组患者PLT（×109/L）治疗前（231.6±27.8），治疗后（204.7±25.6）；APTT治疗前（27.5±5.0）s，治疗后（28.6±4.7）s；PT治疗前（12.6±2.0）s，治疗后（12.8±2.3）s；两组治疗前后差异无统计学意义（P>0.05）；研究不良反应发生率明显低于对照组（P<0.05）。 结论 利伐沙班预防髋关节置换后的下肢静脉血栓疗效更好效果稳定，不良反应降低且更有安全性，疗效得到医师患者的肯定，临床上应当进一步推广应用。

[关键词] 髋关节置换术；利伐沙班；下肢深静脉血栓；疗效；安全性

[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2018）04（c）-0117-03

Curative Effect and Safety of Rivaroxaban after the Hip Joint Replacement Surgery in Preventing the Deep Vein Thrombosis

Kerban·Akeme

Joint trauma department， Bazhou Peoples Hospital， Bazhou，Xinjiang， 841000 China

[Abstract] Objective To study the curative effect and safety of rivaroxaban after the hip joint replacement surgery in preventing the deep vein thrombosis. Methods 150 cases of patients with hip joint replacement surgery admitted and treated in our hospital from February 2012 to May 2015 were convenient selected and randomly divided into two groups with 75 cases in each， the research group took the rivaroxaban orally， while the control group used the subcutaneous injection of low molecular weight heparin injection， and the treatment effect and adverse reactions were compared between the two groups. Results The test values of PLT and APTT were respectively（100～300）×109/L and 32～43 s， which were abnormal after delay for 10 s， and the test value of PT was 11-15 s， and the PLT and APTT before and after treatment in the research group were respectively （213.7±43.1）×109/L， （193.2±27.8）×109/L and （24.9±5.7）s， （31.6±5.9）s， and the PT before and after treatment was respectively （11.5±2.8）s and （12.4±2.6）s， and the PLT in the control group before and after treatment was respectively（231.6±27.8）×109/L and （204.7±25.6）×109/L， and the APTT before and after treatment was respectively （27.5±5.0）s and （28.6±4.7）s， and the PT before and after treatment was respectively （12.6±2.0）s and （12.8±2.3）s， and the difference between the two groups was not obvious（P>0.05）， and the incidence rate of adverse reactions was obviously lower than that in the control group（P<0.05）. Conclusion The curative effect of rivaroxaban after the hip joint replacement surgery in preventing the deep vein thrombosis is steady， which can reduce the adverse reactions with safety， and the curative effect is recognized by the physicians， and it should be further promoted and applied in clinic.

[Key words]Hip joint replacement； Rivaroxaban； Deep vein thrombosis； Curative effect； Safety

下肢靜脉血栓是髋关节置换术后易形成的外科疾病，其发生可致患者肢体肿胀，长期的卧床导致患者活动障碍，甚至丧失活动功能。术中若无抗凝治疗就接受髋关节置换术，发生下肢静脉血栓的概率高达50%左右[1]。目前所用的抗凝药物有低分子肝素，该药物效果显著，在临床上使用较广，可明显降低患者术后不良反应的发生。但该药物的使用必须皮下注射，应用较麻烦，且患者出院后使用也不方便[2]。该次研究方便选取了2012年2月—2015年5月该院收治的髋关节置换术患者150例，探讨髋关节置换术后利伐沙班预防下肢深静脉血栓的疗效与安全性，并在该次研究中取得不错的效果，值得在临床上大力推广，现报道如下。