利伐沙班在髋关节置换术后应用效果.docVIP

利伐沙班在髋关节置换术后应用效果 　　[摘要]目的 探讨利伐沙班预防髋关节置换术后下肢深静脉血栓（DVT）形成的效果。方法 选取我院在2015年2月～2016年8月收治的84例髋关节置换术后患者为研究对象，将其根据不同的治疗方法分观察组、对照组，每组42例。对照组患者术后12 h使用低分子肝素，观察组患者术后6 h口服利伐沙班。比较两组患者术前、术后的凝血功能指标及血小板计数、D-二聚体水平、DVT发生率、切口引流量量及不良反应发生率。结果 观察组术后的PLT为（175.54±24.21）×109/L，APTT为（31.09±2.58）s，与对照组比较差异无统计学意义（P0.05）；观察组术后1、3、7、14 d的D-二聚体水平明显低于对照组（P0.05）；观察组术后切口引流量为（247.56±39.78）ml，与对照组[（252.34±42.24）ml]比较差异无统计学意义（P0.05），观察组的不良反应发生率为7.14%，对照组为16.67%，?勺椴钜煳尥臣蒲б庖澹?P0.05）。结论 对髋关节置换术后患者，采用利伐沙班可显著提高抗凝治疗效果，在预防DVT形成方面同低分子肝素疗效相当，并应用更方便、安全。 　　[关键词]利伐沙班；髋关节置换术；下肢深静脉血栓；应用效果 　　[中图分类号] R687.4 [文献标识码] A [文章编号] 1674-4721（2017）10（b）-0109-03 　　[Abstract]Objective To explore the effect of Rivaroxaban on the prevention of deep vein thrombosis （DVT） of lower extremity after hip joint replacement.Methods From February 2015 to August 2016，84 patients with hip joint replacement treated in our hospital were selected as research objects.According to different therapeutic methods，they weredivided into the observation group and control group，and there were 42 cases in each group.In the control group，low molecular weight heparin （LMWH） was used 12 hours after surgery，while in the observation group，Rivaroxaban of oral administration 6 after hours surgery was adopted.The coagulation function indexes，changes of platelet count，D-dimer value，and volume of incision drainage before and after surgery，and incidence of adverse reactions and DVT were comparatively analyzed.Results PLT was （175.54±24.21）×109/L and activated partial thromboplast in time was （31.09±2.58） s after operation in the observation group，which was not displayed a significant difference between the two groups （P0.05）.D-dimer level 1，3，7 d，and 14 day after surgery in the observation group were much lower than those in the control group （P0.05）.The volume of incision drainage after operation in the observation group was （247.56±39.78） ml，and it was （252.34±42.24） ml in the control group，and there was no statistical difference （P0.05）.The incidence of adv