利伐沙班与低分子肝素用于复杂骨盆髋臼骨折术后下肢深静脉血栓的预防效果比较
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摘要
目的分析利伐沙班与低分子肝素对复杂骨盆髋臼骨折术后下肢深静脉血栓(DVT)的预防效果。方法选取2015年1月—2018年4月收治的复杂骨盆髋臼骨折126例,按用药方法分为低分子肝素组和利伐沙班组,每组63例。观察2组DVT发生情况、血小板(PLT)计数、血红蛋白(Hb)水平、血液流变学、凝血功能变化,并观察不良反应发生情况。结果 2组DVT发生率比较差异无统计学意义(P>0.05)。2组手术前后PLT计数和Hb水平、血液流变学、凝血功能的组内和组间比较差异无统计学意义(P>0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论利伐沙班与低分子肝素在预防复杂骨盆髋臼骨折术后DVT方面均有良好效果,安全性均较高,且利伐沙班为口服用药,依从性较高。
Objective To analyze effect of Rivaroxaban and low molecular weight heparin(LMWH) in prevention of deep venous thrombosis(DVT) of lower extremity in patients with complex pelvic and acetabular fractures after surgery. Methods A total of 126 patients with complex pelvic and acetabular fractures admitted during January 2015 and April 2018 were divided into LMWH group and Rivaroxaban group(n=63 in each group). Incidence rates of DVT, platelet(PLT) counts, hemoglobin(Hb) levels, changes of hemorheology and coagulation function and incidence rates of adverse reactions were observed in two groups. Results There was no significant difference in incidence rate of DVT between two groups(P>0.05). There were no significant differences in PLT count, Hb level, changes of hemorheology and coagulation function before and after surgery in the same group and between two groups(P>0.05). There was no significant difference in incidence rate of adverse reactions between two groups(P>0.05). Conclusion Both Rivaroxaban and low molecular weight heparin have good effect and safety in prevention of DVT in patients with complex pelvic and acetabular fractures after surgery, but Rivaroxaban is more convenient for oral administration.
Objective To analyze effect of Rivaroxaban and low molecular weight heparin(LMWH) in prevention of deep venous thrombosis(DVT) of lower extremity in patients with complex pelvic and acetabular fractures after surgery. Methods A total of 126 patients with complex pelvic and acetabular fractures admitted during January 2015 and April 2018 were divided into LMWH group and Rivaroxaban group(n=63 in each group). Incidence rates of DVT, platelet(PLT) counts, hemoglobin(Hb) levels, changes of hemorheology and coagulation function and incidence rates of adverse reactions were observed in two groups. Results There was no significant difference in incidence rate of DVT between two groups(P>0.05). There were no significant differences in PLT count, Hb level, changes of hemorheology and coagulation function before and after surgery in the same group and between two groups(P>0.05). There was no significant difference in incidence rate of adverse reactions between two groups(P>0.05). Conclusion Both Rivaroxaban and low molecular weight heparin have good effect and safety in prevention of DVT in patients with complex pelvic and acetabular fractures after surgery, but Rivaroxaban is more convenient for oral administration.
引文
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[16] 董明,张显柏,程正辉.比较利伐沙班与低分子肝素对老年转子间骨折股骨近端髓内钉固定术后隐性失血的影响[J].药品评价,2017,14(19):47-49,64.
[17] 龙安华,张立海,李鸿达,等.利伐沙班与低分子肝素预防老年髋部骨折深静脉血栓的有效性和安全性[J].上海医学,2014,37(1):35-38.
[18] 周筠,毕方刚,陈聚伍.利伐沙班与低分子肝素对骨折患者下肢深静脉血栓预防的疗效比较[J].中华实验外科杂志,2015,32(12):3187-3189.
[19] 武通.利伐沙班与低分子肝素预防髋关节置换术后深静脉血栓形成的疗效对比[J].北方药学,2017,14(5):121-122.
[20] 覃业语,王敏,韦知樱,等.利伐沙班与低分子肝素预防老年髋部骨折患者深静脉血栓的疗效和安全性[J].中国老年学杂志,2016,36(17):4268-4269.
[21] 张剑锋,刘建青,沈炳华,等.利伐沙班与低分子肝素预防腰椎手术后下肢深静脉血栓的疗效对比[J].中国新药与临床杂志,2014,33(3):211-214.
[2] 王鹏飞,王宝辉,尚昆,等.骨盆髋臼骨折患者围手术期下肢深静脉血栓形成的发生规律及危险因素分析[J].中华创伤骨科杂志,2017,19(11):941-947.
[3] 萧剑彬,林少芒,张智辉,等.利伐沙班与低分子肝素对预防髋部骨折患者下肢深静脉血栓的比较研究[J].现代诊断与治疗,2014,25(1):1-3.
[4] 宫海峰,张成栋,何蕾,等.利伐沙班与低分子肝素预防骨盆骨折术后患者下肢深静脉血栓的疗效及安全性比较[J].湖南中医药大学学报,2016,18(A2):1350-1351.
[5] 侯玉芬,刘政.下肢深静脉血栓形成诊断及疗效标准(2015年修订稿)[J].中国中西医结合外科杂志,2016,22(5):520-521.
[6] 杨明辉,朱仕文,孙旭,等.骨盆髋臼骨折后深静脉血栓形成的诊断:彩色多普勒超声与静脉造影的比较研究[J].中华创伤骨科杂志,2012,14(5):391-394.
[7] 卜建文,吕云云.多发骨折患者深静脉血栓形成的危险因素分析[J].世界最新医学信息文摘,2017,17(100):20-21.
[8] Jehan F,O'Keeffe T,Khan M,et al.Early thromboprophylaxis with low-molecular-weight heparin is safe in patients with pelvic fracture managed nonoperatively[J].J Surg Res,2017,219:360-365.
[9] 王蕾,黄东旭,刘凯,等.下肢深静脉血栓形成的药物治疗[J].血管与腔内血管外科杂志,2016,2(5):431-434,449.
[10] 吴歌,李贵斌,戴彬,等.利伐沙班与低分子肝素钙预防髋部骨折术后下肢深静脉血栓形成的有效性与安全性[J].中国临床研究,2013,26(1):5-7.
[11] Zou Y,Tian S,Wang Y,et al.Administering aspirin,rivaroxaban and low-molecular-weight heparin to prevent deep venous thrombosis after total knee arthroplasty[J].Blood Coagul Fibrinolysis,2014,25(7):660-664.
[12] 郑和祝,赵海燕.利伐沙班与低分子肝素预防膝关节翻修术后深静脉血栓的临床疗效分析[J].中国药物评价,2018,35(1):39-42.
[13] 陆惠平,刘彦儒,高培培,等.低分子肝素与利伐沙班预防老年患者骨折置换术后双下肢深静脉血栓的有效性和安全性比较[J].中国药房,2017,28(18):2480-2482.
[14] 宋维海,邓国超,刘文宝,等.利伐沙班与低分子肝素预防髋部骨折围术期下肢深静脉血栓形成及不良反应比较[J].中国乡村医药,2017,24(8):28-29.
[15] 白云飞,房体刚,孙瑞.老年全髋关节置换后利伐沙班与低分子肝素预防深静脉血栓形成及失血情况对比[J].中国组织工程研究,2018,22(15):2303-2308.
[16] 董明,张显柏,程正辉.比较利伐沙班与低分子肝素对老年转子间骨折股骨近端髓内钉固定术后隐性失血的影响[J].药品评价,2017,14(19):47-49,64.
[17] 龙安华,张立海,李鸿达,等.利伐沙班与低分子肝素预防老年髋部骨折深静脉血栓的有效性和安全性[J].上海医学,2014,37(1):35-38.
[18] 周筠,毕方刚,陈聚伍.利伐沙班与低分子肝素对骨折患者下肢深静脉血栓预防的疗效比较[J].中华实验外科杂志,2015,32(12):3187-3189.
[19] 武通.利伐沙班与低分子肝素预防髋关节置换术后深静脉血栓形成的疗效对比[J].北方药学,2017,14(5):121-122.
[20] 覃业语,王敏,韦知樱,等.利伐沙班与低分子肝素预防老年髋部骨折患者深静脉血栓的疗效和安全性[J].中国老年学杂志,2016,36(17):4268-4269.
[21] 张剑锋,刘建青,沈炳华,等.利伐沙班与低分子肝素预防腰椎手术后下肢深静脉血栓的疗效对比[J].中国新药与临床杂志,2014,33(3):211-214.