CAJ | 학술논문

目的探讨利伐沙班预防全膝关节置换术后深静脉血栓形成(DVT)的效果和安全性.方法将2011年1月至2011年6月行全膝关节置换的124例患者随机分为两组,术后应用不同的抗凝药,利伐沙班组70例,低分子肝素(LMWH)组54例.观察比较两组DVT发生率、围术期D-二聚体浓度、出血风险相关事件(术中出血量、术后引流量、瘀斑等).结果利伐沙班组无DVT病例发生,DVT发生率为0；LMWH组发生DVT4例,DVT 发生率为7.4％.利伐沙班组DVT发生率、围术期D-二聚体浓度、瘀斑发生率均低于LMWH组,两组间比较差异均有统计学意义(P＜ 0.05).两组患者术中出血量、术后引流量比较差异无统计学意义(P＞0.05).结论利伐沙班在预防人工关节置换术后DVT的疗效和安全性方面优于低分子肝素,抗凝效果好,不增加出血风险.利伐沙班具备可口服、固定剂量、疗效满意、无需监测、不受饮食影响等优点,具有较好的疗效及安全性.
목적 탐토리벌사반예방전슬관절치환술후심정맥혈전형성(DVT)적효과화안전성.방법 장2011년1월지2011년6월행전슬관절치환적124례환자수궤분위량조,술후응용불동적항응약,리벌사반조70례,저분자간소(LMWH)조54례.관찰비교량조DVT발생솔、위술기D-이취체농도、출혈풍험상관사건(술중출혈량、술후인류량、어반등).결과 리벌사반조무DVT병례발생,DVT발생솔위0；LMWH조발생DVT4례,DVT 발생솔위7.4％.리벌사반조DVT발생솔、위술기D-이취체농도、어반발생솔균저우LMWH조,량조간비교차이균유통계학의의(P＜ 0.05).량조환자술중출혈량、술후인류량비교차이무통계학의의(P＞0.05).결론 리벌사반재예방인공관절치환술후DVT적료효화안전성방면우우저분자간소,항응효과호,불증가출혈풍험.리벌사반구비가구복、고정제량、료효만의、무수감측、불수음식영향등우점,구유교호적료효급안전성.
Objective To investigate the efficacy and safety of rivaroxaban in prevention of deep vein thrombosis (DVT) after total knee arthroplasty (TKA).Methods From January 2011 to June 2011,124 patients with total knee arthroplasty were randomized into two groups:rivaroxaban group with 70 cases and low molecular weight heparin (LMWH) group with 54 cases.The incidence rate of DVT,perioperative plasma D-dimeir levels,bleeding risk related events (intraoperative bleeding,postoperative drainage and incidence rate of ecchymosis) were observed.Results There was no DVT occured in rivaroxaban group,the incidence rate of DVT was 0; And there were 4 patients with DVT in LMWH group,the incidence rate of DVT was 7.4％.The incidence rate of DVT,perioperative plasma D-dimer levels,incidence rate of ecchymosis in rivaroxaban group were lower than those in LMWH group,the differences were significant ( P ＜ 0.05).There were no significant differences in intraoperative bleeding and postoperative drainage between the two groups (P ＞ 0.05).Conclusions The efficacy and safety of rivaroxaban in prevention of DVT after TKA are better than those of LMWH.Rivaroxaban can be orally taken,has good anticoagulation effect without increasing the bleeding rate.It does not require laboratory monitoring and has no food interactions.