文档介绍：重庆医科大学硕士研究生学位论文
阿哌沙班和利伐沙班在全膝关节表面置换
术后抗凝效果的对比
摘要
目的观察对比新型口服抗凝药物阿哌沙班与利伐沙班在全膝关
节表面置换术后的抗凝效果。
方法选取 2013 年 10 月份~2014 年 9 月份在重庆医科大学附属
第一医院骨科关节中心行单侧全膝关节表面置换术的患者 60 例进行随
机分组研究,其中阿哌沙班组患者 30 例,术后 24h 起给予阿哌沙班片
mg 口服 bid,连续 14 d;利伐沙班组患者 30 例,术后 24h 起给予
利伐沙班片 10mg 口服 qd, 连续 14 d。观察对比两组患者术后有无静
脉血栓及肺栓塞的形成、术后失血量、皮下瘀斑的发生情况、术后 D-
二聚体的变化幅度、术后术肢周径的变化幅度及人工关节活动度等。
结果术后服药期间,两组患者均无深静脉血栓及肺栓塞的发生,
两组患者术后显性失血量无明显差异(P>);阿哌沙班组患者术
后第 3d、7d 及 14d 的隐性失血量分别低于利伐沙班组患者术后第 3d、
7d 及 14d 的隐性失血量,差异具有统计学意义(P<);阿哌沙班
组术后皮下瘀斑发生率 %(8/30),利伐沙班组皮下瘀斑发生率
%(19/30),差异具有统计学意义(P<);两组患者手术所
用时间、术后 D-二聚体的变化幅度、术肢周径的变化幅度及膝关节的
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重庆医科大学硕士研究生学位论文
活动度均无明显的差异(P>);利伐沙班组术后出现无症状性肌
间血栓患者 1 例,未做特殊处理;所有患者伤口均愈合良好。
结论全膝关节表面置换术后口服阿哌沙班和利伐沙班均能有效
预防下肢静脉血栓的形成,但在整个服药期间,阿哌沙班对患者术后
隐性失血量的影响较小,皮下瘀斑的发生率较低,其临床效果更佳。
关键词:全膝关节表面置换术,阿哌沙班,利伐沙班,隐性失血,
瘀斑,静脉血栓
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重庆医科大学硕士研究生学位论文
THE EFFECTIVENESS OF APIXABAN AND
RIVAROXABAN FOR THOMBOPROPHYLAXIS AFTER
PRIMARY UNILATERAL TOTAL KNEE
ARTHROPLASTY
ABSTRACT
Objective:The main purpose of this study is to contrast the
effectiveness of the new oral anticoagulant--Apixaban and Rivaroxaban
after total knee arthroplasty (TKA).
Methods:The study included 60 patients who were under unilateral
TKA from to Sept. 2014 in the joint center of the First Affiliated
Hospital of Chongqing Medical University. Among them, 30 were for
Apixaban, and the patients were given (oral, bid) of Apixaban for 14
days after surgery; the other 30 were for Rivaroxaban, and the patients were
given 10mg(oral,qd) of Rivaroxaban for 14 days after surgery. Then the deep
venous thrombosis,blood loss, ecchymosis , change of D-dimer
postoperative, change of the perimeter of the operated leg and the ROM of
the joint prosthesis were observed.
Results:No venous thrombosis and pulmonary thromboembolism in
both groups was found during the period of drug tkaking after
was no statistically significant difference in dominant blood loss between
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