CAJ | 학술논문

目的：探讨利伐沙班和那曲肝素在预防人工膝关节表面置换术（ TKA）术后静脉血栓栓塞症（ VTE）的疗效和抗凝并发症方面的差异。方法接受初始单侧膝关节表面置换手术的骨关节炎患者75例，随机分为利伐沙班组（n＝50）和那曲肝素组（n＝25）。监测术后1、3、5 d血常规并记录异体血输血率和输血量，测量术前和术后1、3和5d大腿周径，了解肢体肿胀程度。观察切口愈合情况，记录切口并发症。同时，根据肢体肿胀程度查下肢血管超声诊断或排除VTE。结果利伐沙班组发生1例股深静脉血栓（2.00％），那曲肝素组无VTE发生， VTE发生率无组间统计学差异（ P＞0.05）。两组均无大出血事件发生。利伐沙班组5例发生小出血事件，那曲肝素组为2例，小出血事件发生率无组间统计学差异（ P＞0.05）。利伐沙班组2例切口乙级愈合，那曲肝素组全部甲级愈合，切口感染率无组间统计学差异（ P＞0.05）。利伐沙班异体输血率54.00％，输血量（286.00±302.38）ml，相对那曲肝素组无统计学差异（P＞0.05）。利伐沙班组与那曲肝素组患者术后大腿周径变化总体无组间统计学差异（P＞0.05）。结论本组数据显示利伐沙班预防TKA术后VTE的疗效和出血并发症与那曲肝素大致相当。
목적：탐토리벌사반화나곡간소재예방인공슬관절표면치환술（ TKA）술후정맥혈전전새증（ VTE）적료효화항응병발증방면적차이。방법접수초시단측슬관절표면치환수술적골관절염환자75례，수궤분위리벌사반조（n＝50）화나곡간소조（n＝25）。감측술후1、3、5 d혈상규병기록이체혈수혈솔화수혈량，측량술전화술후1、3화5d대퇴주경，료해지체종창정도。관찰절구유합정황，기록절구병발증。동시，근거지체종창정도사하지혈관초성진단혹배제VTE。결과리벌사반조발생1례고심정맥혈전（2.00％），나곡간소조무VTE발생， VTE발생솔무조간통계학차이（ P＞0.05）。량조균무대출혈사건발생。리벌사반조5례발생소출혈사건，나곡간소조위2례，소출혈사건발생솔무조간통계학차이（ P＞0.05）。리벌사반조2례절구을급유합，나곡간소조전부갑급유합，절구감염솔무조간통계학차이（ P＞0.05）。리벌사반이체수혈솔54.00％，수혈량（286.00±302.38）ml，상대나곡간소조무통계학차이（P＞0.05）。리벌사반조여나곡간소조환자술후대퇴주경변화총체무조간통계학차이（P＞0.05）。결론본조수거현시리벌사반예방TKA술후VTE적료효화출혈병발증여나곡간소대치상당。
Objective To investigate the thromboprophylaxis efficacy as well as the complication incidence given by rivaroxaban and nadroparin after total knee arthroplasty (TKA).Methods Seventy-five patients undergone unilateral TKA with a primary diagnosis of osteoarthritis were randomly separated into a rivaroxaban group (n=50) and a nadroparin group (n=25).The blood routine examination was monitored on the 1 st , 3 rd , and 5 th day postoperatively .The amount and rate of allogeneic blood transfusion were recorded .The leg diameter was measured to understand the degree of swelling .The healing of the incision wound was observed and any incision complications were noted simultaneously . Venous thromboembolism ( VTE ) was diagnosed or excluded based on vascular color-ultrasound examination . Results One case (2.00%) of deep vein thrombosis was identified in the rivaroxaban group in contrast to the absent VTE occurrence in the nadroparin group , but no significant difference in VTE rate was discerned between the two groups ( P>0.05 ) .No major bleeding happened in either group .Five cases of minor bleeding in the rivaroxaban group and two cases in the nadroparin group were recorded , but that showed no intergroup difference (P>0.05).Two cases of class B healing in the rivaroxaban group were recorded and all the cases were healed excellently in the nadroparin group .These healing data again represented no intergroup difference (P>0.05).286.0 ±302.4 ml allogeneic blood was transfused to 54% patients in the rivaroxaban group.However, both the rate and the volume of blood transfusion presented no significant difference in contrast to those of the nadroparin group ( P >0.05 ) .The overall change about the leg diameter of the patients in the rivaroxaban group and the nadroparin group showed no significant difference between the two groups (P>0.05).Conclusion The results of current investigation suggests equivalent thromboprophylaxis efficacy and hemorrhagic complications rate between rivaroxaban and nadroparin .