阿司匹林低分子肝素钠利伐沙班预防膝关节置换术后下肢深静脉血栓形成研究

doi:10.3969/j.issn.1006-6233.2020.04.002

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Abstract Objective: To investigate the preventive effect of aspirin, low molecular weight heparin sodium and rivashaban on deep venous thrombosis of lower extremity after knee arthroplasty. Methods: 200 patients with total knee replacement in our hospital from July 2017 to April 2019 were selected as the subject of the study.The patients with the group A were given an oral rivasahan treatment, and the povtients in group B was given an oral aspirin, and the group C was given low molecular heparin sodium injection treatment. The prothrombin time (PT), activated partial thromboplastin time (APTT), D-dimer) and platelet value (Plt) were observed and compared among the three groups, and the incidence of deep venous thrombosis of lower extremity was recorded. Results: After anticoagulation, the number of effective treatment cases in group A (66 cases) was significantly higher than that in group B (44 cases, 68.75%) and group C (47 cases, 71.21%). The total effective treatment rate was 94.29%, with a significant difference (P<0.05); There was no significant difference in Pt, APTT and PLT indexes between group A and group B (P>0.05), and there was significant difference in three indexes between group A and group C (P<0.05); One day, one week and 15 days after the treatment, the D-dimer value of group A was significantly lower than that of group B (P<0.05); one week and 15 days after the treatment, the D-dimer value of group A was significantly lower than that of group C (P<0.05); two patients in group A had DVT, the incidence was 5.88%; six patients in group B, the incidence was 17.65%; ten patients in group C, the incidence was 29.4%. There was no significant difference between the two groups (χ² = 2.267, P = 0.132) and the two groups (DVT χ²=1.308, P=0.253,P=0.253, P<0.05). Conclusion: Compared with low molecular weight heparin, aspirin has a higher therapeutic safety, but a lower therapeutic effect; rivaroxaban has a higher anticoagulant effect, but a higher incidence of occult blood loss and incision complications. Therefore, the anticoagulation needs of patients can be reasonably selected according to the actual situation.

Key words： Knee arthroplasty Rivasaban Aspirin Low molecular weight heparin sodium Thrombus

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2020.04.002 OR http://www.hbyxzzs.cn/EN/Y2020/V26/I4/533

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