中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2013年
17期
3140-3147
,共8页
骨关节植入物%骨与关节循证医学%Xa因子直接抑制剂%低分子量%肝素%全膝置换%静脉血栓形成%Meta分析
骨關節植入物%骨與關節循證醫學%Xa因子直接抑製劑%低分子量%肝素%全膝置換%靜脈血栓形成%Meta分析
골관절식입물%골여관절순증의학%Xa인자직접억제제%저분자량%간소%전슬치환%정맥혈전형성%Meta분석
bone and joint implants%evidence-based medicine%direct factor Xa inhibitor%low molecular weight%heparin%total knee arthroplasty%venous thrombosis%Meta-analysis
背景:直接Xa因子抑制剂开始在预防和治疗血栓方面发挥重要作用,与低分子量肝素相比其在预防全膝关节置换后血栓形成中的疗效与安全性尚不清楚.
目的:探讨直接Xa因子抑制剂和低分子量肝素预防全膝关节置换后深静脉血栓的优劣.
方法:电子检索MEDLINE,EMBASE,Cochrane图书馆、CBM,CNKI等数据库,并辅以手工检索,全面查找国内外比较直接Xa因子抑制剂和低分子量肝素预防全膝关节置换后深静脉血栓的随机对照试验.根据Cochrane手册提出的文献质量评价标准对纳入研究进行质量评价,并应用统计软件Stata12.0进行数据分析.
结果与结论:直接Xa因子抑制剂较低分子量肝素可显著降低全膝关节置换患者症状性深静脉血栓发生率(P<0.05),且不增加出血风险,2组患者肺栓塞和随访期内死亡率差异无显著性意义(P>0.05).提示在全膝关节置换后深静脉血栓的预防中,直接Xa因子抑制剂较低分子量肝素更加安全、有效和方便.
揹景:直接Xa因子抑製劑開始在預防和治療血栓方麵髮揮重要作用,與低分子量肝素相比其在預防全膝關節置換後血栓形成中的療效與安全性尚不清楚.
目的:探討直接Xa因子抑製劑和低分子量肝素預防全膝關節置換後深靜脈血栓的優劣.
方法:電子檢索MEDLINE,EMBASE,Cochrane圖書館、CBM,CNKI等數據庫,併輔以手工檢索,全麵查找國內外比較直接Xa因子抑製劑和低分子量肝素預防全膝關節置換後深靜脈血栓的隨機對照試驗.根據Cochrane手冊提齣的文獻質量評價標準對納入研究進行質量評價,併應用統計軟件Stata12.0進行數據分析.
結果與結論:直接Xa因子抑製劑較低分子量肝素可顯著降低全膝關節置換患者癥狀性深靜脈血栓髮生率(P<0.05),且不增加齣血風險,2組患者肺栓塞和隨訪期內死亡率差異無顯著性意義(P>0.05).提示在全膝關節置換後深靜脈血栓的預防中,直接Xa因子抑製劑較低分子量肝素更加安全、有效和方便.
배경:직접Xa인자억제제개시재예방화치료혈전방면발휘중요작용,여저분자량간소상비기재예방전슬관절치환후혈전형성중적료효여안전성상불청초.
목적:탐토직접Xa인자억제제화저분자량간소예방전슬관절치환후심정맥혈전적우렬.
방법:전자검색MEDLINE,EMBASE,Cochrane도서관、CBM,CNKI등수거고,병보이수공검색,전면사조국내외비교직접Xa인자억제제화저분자량간소예방전슬관절치환후심정맥혈전적수궤대조시험.근거Cochrane수책제출적문헌질량평개표준대납입연구진행질량평개,병응용통계연건Stata12.0진행수거분석.
결과여결론:직접Xa인자억제제교저분자량간소가현저강저전슬관절치환환자증상성심정맥혈전발생솔(P<0.05),차불증가출혈풍험,2조환자폐전새화수방기내사망솔차이무현저성의의(P>0.05).제시재전슬관절치환후심정맥혈전적예방중,직접Xa인자억제제교저분자량간소경가안전、유효화방편.
@@@@BACKGROUND:Direct factor Xa inhibitors play an important role in the prevention and treatment of venous thromboembolism. However, the efficacy and safety of direct factor Xa inhibitors in the prevention of venous thromboembolism in the patients that undergoing total knee arthroplasty is not clear when compared with the low-molecular-weight heparin. @@@@OBJECTIVE:To explore the pros and cons of direct factor Xa inhibitor and low-molecular-weight heparin in the prevention of deep venous thromboembolism after total knee arthroplasty. @@@@METHODS:A computer-based online search was performed in MEDLINE database, EMBASE database, Cochrane Library, CBM database and CNKI database, supplemented by manual searches to find the randomized trials on the comparison of direct factor Xa inhibitor and low-molecular-weight heparin in the prevention of deep venous thromboembolism after total knee arthroplasty. The quality of included studies was evaluated by quality assessment standards proposed by the Cochrane Handbook, and data analysis was performed with Stata12.0 software. @@@@RESULTS AND CONCLUSION:Compared with low-molecular-weight heparin, direct factor Xa inhibitor can significantly reduce the incidence of symptomatic deep venous thromboembolism without increasing bleeding risk (P<0.05), and there were no significant differences in mortality rate during fol ow-up period and pulmonary embolism between two groups (P>0.05). In the prevention of deep venous thromboembolism after total knee arthroplasty, direct factor Xa inhibitor is more secure, effective and convenient than low-molecular-weight heparin.
