CAJ | 학술논문

目的：探讨膝关节单髁置换术后抗凝药物使用时机。方法进行前瞻随机对照研究，根据纳入／排除标准，选取2013年9月至2014年2月在西安交通大学第二附属医院骨一科行膝关节单髁置换术病例，以随机编码法进行随机分组。术后于不同时间初次应用抗凝药物：6～12 h（ A组）、12～24 h（B组）及24～48 h（C组）。术后患者口服利伐沙班片，10 mg，QD，共21 d。对比分析各组患者术前、术后引流量、总失血量、隐性失血量、血红蛋白含量及降低量、血小板计数、APTT、PT、FIB、患肢大小腿周径等指标的变化。结果共纳入45例研究样本，每组15例。各组术前、术后在引流量、总失血量、隐性失血量、血红蛋白含量及降低量、血小板计数、APTT、PT、FIB及大、小腿周径方面比较差异无统计学意义。结论膝关节单髁置换术后不同时段抗凝治疗对患者术后出血引流量、失血量、血红蛋白及凝血功能无显著性影响，抗凝效果无统计学差别。
목적：탐토슬관절단과치환술후항응약물사용시궤。방법진행전첨수궤대조연구，근거납입／배제표준，선취2013년9월지2014년2월재서안교통대학제이부속의원골일과행슬관절단과치환술병례，이수궤편마법진행수궤분조。술후우불동시간초차응용항응약물：6～12 h（ A조）、12～24 h（B조）급24～48 h（C조）。술후환자구복리벌사반편，10 mg，QD，공21 d。대비분석각조환자술전、술후인류량、총실혈량、은성실혈량、혈홍단백함량급강저량、혈소판계수、APTT、PT、FIB、환지대소퇴주경등지표적변화。결과공납입45례연구양본，매조15례。각조술전、술후재인류량、총실혈량、은성실혈량、혈홍단백함량급강저량、혈소판계수、APTT、PT、FIB급대、소퇴주경방면비교차이무통계학의의。결론슬관절단과치환술후불동시단항응치료대환자술후출혈인류량、실혈량、혈홍단백급응혈공능무현저성영향，항응효과무통계학차별。
Objective To investigate the timing of anticoagulant application following unicompartmental knee arthroplasty .Methods A prospective randomized controlled study was performed according to the inclusion and exclusion criteria . The patients undergoing unicompartmental knee arthroplasty during September 2013 to February 2014 in the orthopaedics department were selected and divided into group A, B and C randomly.Oral rivaroxaban (10 mg, QD) was used as anticoagulation therapy in the three groups at 6-12 h, 12-24 h, 24-48 h after the surgery respectively for 21 days.The drainage , total blood loss , occult blood loss , hemoglobin amount and loss , preoperative and postoperative data of platelet count , activated partial thromboplastin time ( APTT ) and prothrombin time ( PT ) , fibrinogen ( FIB) , and the circumferences of the thigh and calf of the invovled limb in each group were determined.Results Forty -five patients (15 per group) were enrolled in this study.No significant difference was found in the drainage , total and occult blood losses , hemoglobin amount and hemoglobin loss, the preoperative and postoperative data of platelet count , APTT, PT, and FIB among the groups .No significant difference was found in the thigh circumference and calf circumference . Conclusion Anticoagulation treatment at different time points does not affect the drainage , blood loss , hemoglobin level and coagulation function;the anticoagulation effects are the same .