CAJ | 학술논문

　　目的研究血液凝固性在全髋关节置换术前、后的改变以及术后服用利伐沙班对其影响。方法随机选择2011年在我科行全髋关节置换术的患者66例。所有患者术后第1天开始口服利伐沙班，并分别于术前、术后第1天、术后第4天行血栓弹力图(thromboelastography，TEG)检查。比较各阶段TEG重要指标的差异。结果全髋关节置换术后TEG各指标中凝血反应时间(r)、血细胞凝集块形成时间(k)、凝血时间(r+k)值短于术前，血细胞凝集块形成速率(α)、最大振幅(ma)、凝血指数(CI)值高于术前，差异有统计学意义；术后服用利伐沙班后TEG各指标中r、r+k时间长于服药前，差异有统计学意义；k、α、ma、CI无显著变化，差异无统计学意义。结论全髋关节置换术可明显增加患者的血液凝固性，而增加血栓风险；术后短期口服利伐沙班可降低血液凝固性。
　　목적연구혈액응고성재전관관절치환술전、후적개변이급술후복용리벌사반대기영향。방법수궤선택2011년재아과행전관관절치환술적환자66례。소유환자술후제1천개시구복리벌사반，병분별우술전、술후제1천、술후제4천행혈전탄력도(thromboelastography，TEG)검사。비교각계단TEG중요지표적차이。결과전관관절치환술후TEG각지표중응혈반응시간(r)、혈세포응집괴형성시간(k)、응혈시간(r+k)치단우술전，혈세포응집괴형성속솔(α)、최대진폭(ma)、응혈지수(CI)치고우술전，차이유통계학의의；술후복용리벌사반후TEG각지표중r、r+k시간장우복약전，차이유통계학의의；k、α、ma、CI무현저변화，차이무통계학의의。결론전관관절치환술가명현증가환자적혈액응고성，이증가혈전풍험；술후단기구복리벌사반가강저혈액응고성。
Objective To study the blood coagulation before and after total hip arthroplasty (THA) and the effect of rivaroxaban on blood coagulation after THA. Methods Sixty-six patients who underwent THA in our department in 2011 were included in this study. They began to have oral rivaroxaban on day 1 after operation and received thromboelastography (TEG) before THA and on days 1 and 4 after THA. Difference in TEG findings at different stages was compared. Results TEG showed that the coagulation reaction time(r), blood cell clot formation time(k)and coagulation time(r+k)were significantly shorter while the blood cell clot formation rate(α), maximal amplitude (ma)and coagulation index(CI)were significantly higher after THA than before THA(P < 0.05). The r and r+k were significantly longer after taking rivaroxaban than before taking rivaroxaban(P<0.05). However, no significant difference was found in k,α, ma and CI before and after taking rivaroxaban. Conclusion THA can significantly increase blood coagulation and thrombosis risk. Short-term oral administration of rivaroxaban can decrease blood coagulation.