利伐沙班与那曲肝素对全髋关节置换术后患者失血量的影响对比
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摘要
目的对比研究利伐沙班与那曲肝素对全髋关节置换术(THA)后患者失血量的影响。方法回顾性分析该院2017年4月—2018年4月期间收治的112例行THA术患者的临床资料,按照术后给予药物不同分成两组,观察组(口服利伐沙班,58例)和对照组(皮下注射那曲肝素,54例)。对比观察两组患者术前及术后1 d、3 d、5 d血红蛋白(Hb)水平,计算两组患者隐性失血量、显性失血量及失血总量,并对患者术后2、7d髋关节疼痛程度进行评分。结果对照组患者与观察组患者术前及术后1 d、3 d、5 d Hb水平比较,均差异无统计学意义(P>0.05)。观察组患者隐性失血量及总失血量均低于对照组[隐性失血量:(482.21±29.2) mL vs (578.8±31.3) mL;总失血量:(587.9±35.3) m L vs (675.2±34.0) mL],差异有统计学意义(t=16.90,13.31,P<0.05)。两组患者术后2 d、7 d髋关节疼痛程度评分比较,差异无统计学意义(P>0.05)。结论利伐沙班对THA术后患者失血量的影响优于那曲肝素,在一定程度上利于降低患者的术后失血量。
Objective To compare and study the effect of rivaroxaban and nadroparin on the blood loss of patients after the total hip arthroplasty. Methods The clinical data of 112 cases with THA surgery admitted and treated in our hospital from April 2017 to April 2018 were retrospectively analyzed, and the patients were divided into two groups according to different drugs, the observation group with 58 cases took the rivaroxaban orally, while the control group with 54 cases used the hypodermic injection, and the HB levels on the 1 d, 3 d, 5 d after surgery of the two groups were observed and compared, and the hidden blood loss, dominant blood loss and total blood loss of the two groups were calculated, and the pains degrees of hip joint on 2 d and 7 d after surgery were marked. Results There were no obvious differences in the HB levels on the 1 d, 3 d, 5 d before and after surgery between the control group and the observation group(P>0.05), and the hidden blood loss and total blood loss in the observation group were lower than those in the control group, [hidden blood loss(482.21±29.2) mL vs(578.8±31.3) mL; total blood loss:(587.9±35.3)mL vs(675.2±34.0)mL], and the differences were statistically significant(t=16.90, 13.31, P<0.05), and there were no obvious differences in the hip joint pains degree on 2 d and 7 d after surgery between the two groups(P>0.05). Conclusion The effect of rivaroxaban on the blood loss of patients after THA surgery is better than that of nadroparin, which is conductive to reducing the postoperative blood loss to a certain degree.
Objective To compare and study the effect of rivaroxaban and nadroparin on the blood loss of patients after the total hip arthroplasty. Methods The clinical data of 112 cases with THA surgery admitted and treated in our hospital from April 2017 to April 2018 were retrospectively analyzed, and the patients were divided into two groups according to different drugs, the observation group with 58 cases took the rivaroxaban orally, while the control group with 54 cases used the hypodermic injection, and the HB levels on the 1 d, 3 d, 5 d after surgery of the two groups were observed and compared, and the hidden blood loss, dominant blood loss and total blood loss of the two groups were calculated, and the pains degrees of hip joint on 2 d and 7 d after surgery were marked. Results There were no obvious differences in the HB levels on the 1 d, 3 d, 5 d before and after surgery between the control group and the observation group(P>0.05), and the hidden blood loss and total blood loss in the observation group were lower than those in the control group, [hidden blood loss(482.21±29.2) mL vs(578.8±31.3) mL; total blood loss:(587.9±35.3)mL vs(675.2±34.0)mL], and the differences were statistically significant(t=16.90, 13.31, P<0.05), and there were no obvious differences in the hip joint pains degree on 2 d and 7 d after surgery between the two groups(P>0.05). Conclusion The effect of rivaroxaban on the blood loss of patients after THA surgery is better than that of nadroparin, which is conductive to reducing the postoperative blood loss to a certain degree.
引文
[1]林佳杰,唐毓金,谢克恭.前外侧入路全髋置换术的研究进展[J].中国骨与关节损伤杂志,2016, 31(6):670-672.
[2]尹星华,周一新,唐杞衡,等.人工髋膝关节置换术后症状性静脉血栓栓塞性疾病的危险因素分析[J].中国矫形外科杂志,2016,24(19):1765-1769.
[3]苗绍刚,张锡光,陆景华,等.三种抗凝药物在单侧全膝关节置换术后预防静脉血栓性疾病的病例对照研究[J].中国骨伤,2015,28(10):893-896.
[4]吕雪彩.不同容量水平对单膝关节置换老年患者循环及术后恢复的影响[D].北京:中国人民解放军医学院,2016.
[5]卢志华,熊传芝,颜连启,等.全膝置换围手术期失血量因素分析[J].北华大学学报:自然版,2016,17(2):236-239.
[6]陶萍.应用VAS评分对骨折术后患者实施疼痛干预的护理[J].中国伤残医学,2015,23(20):135-136.
[7]杨荣,张浩,舒帆,等.抗凝药物对老年股骨转子间骨折术患者围手术期的影响[J].现代实用医学,2017,29(7):918-919.
[8]任小婵,罗选娟,杨欢,等.新型口服抗凝药的临床应用研究进展[J].中华全科医学,2018,16(4):615-619,666.
[9]易春智,陈锦伦,李肇宏,等.利伐沙班与依诺肝素钠对髋膝关节置换术后下肢深静脉血栓形成及围手术期隐性失血的影响[J].中医正骨, 2016,28(1):17-19.
[10]盂庆奇,张延祠,王敏,等.低分子肝素及利伐沙班预防全髋关节置换术后失血的观察[J].现代临床医学,2015,41(4):249-251.
[2]尹星华,周一新,唐杞衡,等.人工髋膝关节置换术后症状性静脉血栓栓塞性疾病的危险因素分析[J].中国矫形外科杂志,2016,24(19):1765-1769.
[3]苗绍刚,张锡光,陆景华,等.三种抗凝药物在单侧全膝关节置换术后预防静脉血栓性疾病的病例对照研究[J].中国骨伤,2015,28(10):893-896.
[4]吕雪彩.不同容量水平对单膝关节置换老年患者循环及术后恢复的影响[D].北京:中国人民解放军医学院,2016.
[5]卢志华,熊传芝,颜连启,等.全膝置换围手术期失血量因素分析[J].北华大学学报:自然版,2016,17(2):236-239.
[6]陶萍.应用VAS评分对骨折术后患者实施疼痛干预的护理[J].中国伤残医学,2015,23(20):135-136.
[7]杨荣,张浩,舒帆,等.抗凝药物对老年股骨转子间骨折术患者围手术期的影响[J].现代实用医学,2017,29(7):918-919.
[8]任小婵,罗选娟,杨欢,等.新型口服抗凝药的临床应用研究进展[J].中华全科医学,2018,16(4):615-619,666.
[9]易春智,陈锦伦,李肇宏,等.利伐沙班与依诺肝素钠对髋膝关节置换术后下肢深静脉血栓形成及围手术期隐性失血的影响[J].中医正骨, 2016,28(1):17-19.
[10]盂庆奇,张延祠,王敏,等.低分子肝素及利伐沙班预防全髋关节置换术后失血的观察[J].现代临床医学,2015,41(4):249-251.