CAJ | 학술논문

背景:目前大多数医院采取全髋关节置换后应用抗凝药物方案来预防静脉血栓栓塞,但仍存在一定的静脉血栓栓塞发生率,能否采用置换前后联合用药方案,既不增加出血风险又能更好地降低静脉血栓栓塞发生率? 目的:比较置换前维生素E联合置换后利伐沙班与仅置换后利伐沙班预防全髋关节置换后静脉血栓栓塞的有效性及安全性. 方法:选择2010年1月至2012年3月在潍坊医学院附属益都中心医院等4所医院的全髋关节置换患者3656例,随机分试验组(n=1830)和对照组(n=1826),前者置换前给予维生素E联合置换后给予利伐沙班,后者置换前给予安慰剂联合置换后给予利伐沙班. 结果与结论:与对照组相比,试验组总静脉血栓栓塞事件发生率低(P <0.01),而大出血事件发生率二者接近(P >0.05).说明置换前维生素E联合置换后利伐沙班比仅置换后利伐沙班可更有效预防全髋关节置换后静脉血栓栓塞的发生,且并未额外增加出血风险.
배경:목전대다수의원채취전관관절치환후응용항응약물방안래예방정맥혈전전새,단잉존재일정적정맥혈전전새발생솔,능부채용치환전후연합용약방안,기불증가출혈풍험우능경호지강저정맥혈전전새발생솔? 목적:비교치환전유생소E연합치환후리벌사반여부치환후리벌사반예방전관관절치환후정맥혈전전새적유효성급안전성. 방법:선택2010년1월지2012년3월재유방의학원부속익도중심의원등4소의원적전관관절치환환자3656례,수궤분시험조(n=1830)화대조조(n=1826),전자치환전급여유생소E연합치환후급여리벌사반,후자치환전급여안위제연합치환후급여리벌사반. 결과여결론:여대조조상비,시험조총정맥혈전전새사건발생솔저(P <0.01),이대출혈사건발생솔이자접근(P >0.05).설명치환전유생소E연합치환후리벌사반비부치환후리벌사반가경유효예방전관관절치환후정맥혈전전새적발생,차병미액외증가출혈풍험.
BACKGROUND:Currently, the antithrombotic are commonly used for the prevention of venous thromboembolism after total hip arthroplasty, but there is stil a certain incidence of venous thromboembolism. Is it possible to reduce the incidence of venous thromboembolism better while not increasing the risk of bleeding if some drugs are applied combinedly before and after operation? @@@@OBJECTIVE:To compare the efficacy and safety of preventing venous thromboembolism after total hip arthroplasty by applying preoperation vitamin E combined with postoperation rivaroxaban versus postoperation rivaroxaban alone. @@@@METHODS:Total y 3 656 patients undergoing total hip arthroplasty in four hospitals, including Affiliated Yidu Central Hospital of Weifang Medical University from January 2010 to March 2012 were randomly divided into experimental group (n=1 830) and control group (n=1 826). The experimental group was given preoperation vitamin E combined with postoperation rivaroxaban therapy, while the control group was given preoperation placebo combined with postoperation rivaroxaban therapy. @@@@RESULTS AND CONCLUSION:Compared with the control group, the incidence of total venous thromboembolism event was lower in the experimental group (P<0.01), but the incidence of major bleeding event was approximate in two groups (P>0.05). It indicates that preoperation vitamin E combined with postoperation rivaroxaban can be more effective after total hip arthroplasty than only postoperation rivaroxaban applying in preventing venous thromboembolism, without an extra risk of bleeding.