不同方法对全髋关节置换术后患者静脉血栓栓塞预防效果的比较

发布时间：2018-02-13 10:56

本文关键词： 全髋关节置换术静脉血栓栓塞症利伐沙班低分子肝素　出处：《中国血管外科杂志(电子版)》2016年04期 　论文类型：期刊论文

【摘要】：目的分析利伐沙班与低分子肝素预防全髋关节置换术后静脉血栓栓塞症(VTE)的临床效果。方法选择2011年2月至2015年4月本院择期接受全髋关节置换术的100例患者作为研究对象,随机分为A、B组各50例。A组口服利伐沙班预防术后VTE,B组采用注射低分子肝素作预防处理,监测两组术前、术后5周凝血指标凝血酶原时间(PT)、D-二聚体(D-D)、纤维蛋白原(FIB)水平的变化,检测血小板计数(PLT)及血红蛋白(Hb)水平的变化,测定两组股浅静脉内径、乆静脉内径的变化,统计VTE及不良反应发生率。结果术后5、8周,两组PT均延长,D-D、FIB上升,与同组术前比较差异有统计学意义(P0.05),A组D-D、FIB上升幅度低于B组(P0.05);两组Hb均降低,A组Hb降低幅度低于B组(P0.05),PLT对比差异无统计学意义(P0.05);两组股浅静脉内径无明显变化,A组乆静脉内径降低,明显低于同组术前及B组(P0.05);A组DVT、PTE及总VTE发生率略低于B组,但差异无统计学意义(P0.05);两组术后不良事件发生率对比差异无统计学意义(P0.05)。结论采用利伐沙班预防全髋关节置换术后VTE,抗凝效果好,可降低VTE不良血事件发生率,安全性高。
[Abstract]:Objective to analyze the clinical effect of Levasaban and low molecular weight heparin (LMWH) in the prevention of venous thromboembolism (VTE) after total hip arthroplasty (THR). Patients in group A were randomly divided into group A (n = 50) and group A (n = 50). Group B was treated with injection of low molecular weight heparin (LMWH) as prophylaxis, and the changes of prothrombin time and fibrinogen (FIBs) were monitored before and 5 weeks after operation. The changes of platelet count (PLT) and hemoglobin (HB) levels, the changes of superficial femoral vein diameter and the diameter of the superficial femoral vein, the incidence of VTE and adverse reactions were measured. Results 5 weeks after operation, the PT of both groups prolonged the increase of D-DG FIB. There was significant difference between the two groups before operation. There was no significant difference in the increase of D-DV FIB between group A and group B, the decrease of HB in group A was lower than that in group B, and there was no significant difference in contrast between group A and group B (P 0.05), and there was no significant change in the diameter of superficial femoral vein between two groups. The internal diameter of vein was decreased in group A, The incidence of PTE and total VTE in group A was lower than that in group B and group B before operation, and the incidence of PTE and total VTE in group A was slightly lower than that in group B. However, there was no significant difference in the incidence of adverse events between the two groups (P 0.05). Conclusion the anticoagulant effect of Levasaban in the prevention of VTE after total hip arthroplasty is good, the incidence of adverse blood events in VTE can be reduced and the safety is high.
【作者单位】：广州医科大学附属第三医院骨科;
【分类号】：R687.4;R543.6

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