利伐沙班预防骨科大手术后下肢深静脉血栓形成的效果

杨卫国

（兴平市中医院，陕西 咸阳，713100）

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摘要：

目的 观察利伐沙班在预防骨科大手术后下肢深静脉血栓形成中的效果。方法 将我院收治的120例骨科手术患者根据不同治疗方法分为观察组（70例）和对照组（50例），两组患者行骨科大手术后均使用积极护理和物理抗凝治疗，观察组患者采用利伐沙班抗凝，对照组患者采用低分子肝素钠注射液抗凝，根据患者不同的手术类型决定具体抗凝时间，对比两组患者手术后出血量、凝血酶原时间、血红蛋白、血小板计数及下肢深静脉血栓（DVT）发生率。结果 两组患者术后出血量、服药后凝血酶原时间差异无统计学意义（P>0.05）；两组患者用药后血红蛋白水平明显下降，停药后，血红蛋白水平上升（P<0.05）；两组患者服药后血小板计数都有明显降低，停药后血小板计数上升（P<0.05），观察组超过正常血小板计数范围有4例（5.71%），低于对照组的15例（30.00%）（P<0.05）；两组患者DVT发生率、不良反应发生率比较差异有统计学意义（P<0.05）。结论 利伐沙班预防DVT较低分子肝素注射液具有更好的疗效和安全性。

关键词：利伐沙班；骨科大手术；下肢深静脉血栓

中图分类号：R687.3文献标志码：A文章编号：2096-1413(2017)11-0012-02

The effect of rivaroxaban in deep venous thrombosis prevention after orthopaedic major surgery
YANG Wei-guo
(Traditional Chinese Medicine of Xingping, Xianyang 713100, China)

ABSTRACT: Objective To observe the effect of rivaroxaban in deep venous thrombosis prevention after orthopaedic major surgery. Methods A total of 120 cases of orthopaedics patients were divided into observation group (70 cases) and control group (50 cases) according to different therapies. Patients in both groups used positive nursing and postoperative physical anticoagulation, the observation group received rivaroxaban for anticoagulants, while the control group accepted low -molecular-weight heparins sodium injection, the decision on the specific time of anticoagulant were made depending on the type of patients' surgery. The blood loss, blood coagulation time, hemoglobin and blood platelet count and incidence of deep vein thrombosis (DVT) of lower limbs postoperation were compared between the two groups. Results There had no significant difference of blood loss and blood coagulation time between the two groups (P >0.05). After taking medicine, hemoglobin count of the two groups decreased (P<0.05), and after discontinuation they increased (P<0.05). After taking medicine, the blood platelet count of the two groups decreased(P<0.05), and they increased after discontinuation (P<0.05),there were 4 case (5.71%) beyond the normal range in the observation group, which were lower than 15 cases (30.00%) in the control group (P<0.05). After discontinuation, the two groups returned to normal. The differences of DVT and adverse reactions incidence rates of the two groups were significant (P <0.05). Conclusion Compared with low-molecular-weight heparins sodium injection, the rivaroxaban on DVT has better efficacy and safety.
KEYWORDS: rivaroxaban; orthopaedic major surgery; lower extremity deep vein thrombosis

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