CAJ | 학술논문

目的通过比较利伐沙班与低分子量肝素(LMWH)在初次全髋关节置换(THA)术后下肢深静脉血栓形成(DVT)防治中的作用,评估利伐沙班的有效性、安全性以及其足疗程应用防治血栓的必要性. 方法对2008年1月至2010年4月收治的136例单侧初次行THA患者进行回顾性分析,根据术后预防DVT使用药物不同分为利伐沙班组和LMWH组,每组各68例.利伐沙班组男28例,女40例；平均(61.6±10.7)岁,体质量平均(63.9±11.2) kg.LMWH组男31例,女37例；平均(60.3±12.4)岁,体质量平均(65.5±9.8) kg.两组患者治疗前一般资料差异无统计学意义,具有可比性.LMWH组术后应用时间为1周,利伐沙班组术后应用时间分别为2周38例,5周30例.比较分析两组患者应用药物前、后血红蛋白、血小板、凝血功能情况,以及症状DVT发生率、轻微和严重出血事件发生率. 结果两组患者手术前、后血红蛋白、血小板、凝血功能、轻微和严重出血事件发生率比较差异均无统计学意义(P＞ 0.05),LMWH组症状DVT发生率为7.4％,利伐沙班组为0,两组比较差异有统计学意义(P＜0.05). 结论与LMWH比较,初次THA术后DVT防治中利伐沙班更安全、有效,足疗程抗凝十分必要.
목적 통과비교리벌사반여저분자량간소(LMWH)재초차전관관절치환(THA)술후하지심정맥혈전형성(DVT)방치중적작용,평고리벌사반적유효성、안전성이급기족료정응용방치혈전적필요성. 방법 대2008년1월지2010년4월수치적136례단측초차행THA환자진행회고성분석,근거술후예방DVT사용약물불동분위리벌사반조화LMWH조,매조각68례.리벌사반조남28례,녀40례；평균(61.6±10.7)세,체질량평균(63.9±11.2) kg.LMWH조남31례,녀37례；평균(60.3±12.4)세,체질량평균(65.5±9.8) kg.량조환자치료전일반자료차이무통계학의의,구유가비성.LMWH조술후응용시간위1주,리벌사반조술후응용시간분별위2주38례,5주30례.비교분석량조환자응용약물전、후혈홍단백、혈소판、응혈공능정황,이급증상DVT발생솔、경미화엄중출혈사건발생솔. 결과 량조환자수술전、후혈홍단백、혈소판、응혈공능、경미화엄중출혈사건발생솔비교차이균무통계학의의(P＞ 0.05),LMWH조증상DVT발생솔위7.4％,리벌사반조위0,량조비교차이유통계학의의(P＜0.05). 결론 여LMWH비교,초차THA술후DVT방치중리벌사반경안전、유효,족료정항응십분필요.
Objective To analyze the efficacy and safety of rivaroxaban versus low-molecular-weight heparin (LMWH) for prevention of deep venous thrombosis (DVT) after primary total hip arthroplasty(THA).Methods From January 2008 to April 2010,136 cases received in our department prophylactic DVT treatment with rivaroxaban or LMWH after unilateral primary THA.There were 68 patients in each group.The duration of LMWH prophylaxis was one week,and the durations of rivaroxaban prophylaxis were 2 weeks in 38 cases and 5 weeks in 30 cases.The levels of hemoglobin (Hb) and platelet (Plt),prothrombin time(PT),activated partial thromboplastin time (APTT),minor bleeding and major bleeding events were measured and compared between the LMWH and rivaroxaban groups.There was no significant difference between groups in the general data of the patients( P ＞ 0.05).Results There were no significant differences regarding the levels of Hb and Plt,PT and APTT between the 2 groups preoperation or postoperation ( P ＞ 0.05).The minor bleeding and major bleeding events were similar in 2 groups ( P ＞ 0.05).A significant difference in DVT incidence was found between the 2 groups,with 0％ in the rivaroxaban group and 7.4％ in the LMWH group( P ＜ 0.05).Conclusion Since rivaroxaban is more effective and reliable than LMWH in DVT prevention after primary total hip arthroplasty,intervention of sufficient duration is necessary.