不同剂量利伐沙班对老年髋关节置换术患者凝血功能 及下肢深静脉血栓的影响

Objective: To investigate the effects of different doses of rivaroxaban on coagulation function and deep venous thrombosis (DVT) in elderly patients undergoing hip replacement. Methods: A total of 200 patients, who underwent hip replacement in Jingzhou Central Hospital of Hubei Province from June 2013 to June 2016, were selected and randomly divided into group I (n=100) and group II (n=100). After surgery, group I and group II were treated with 5 mg and 10 mg rivaroxaban orally to prevent DVT. Fibrinogen (Fbg). prothrombin time (PT). thrombin time (TT). activated partial thromboplastin time (APTT) and D-dimer (D-D) were detected before surgery and Id and 7d after surgery. At the same time, lower extremity color Doppler ultrasound was used to determine the occurrence of DVT. the clinical bleeding events were observed. Results: The lewis of Fbg in the two groups were decreased significantly Id after surgery’, and PT was significantly prolonged (all P<0.05). 7d after surgery, the levels of Fbg in the two groups were significantly higher than those of Id after surgery’, and PT was significantly shortened (all P<0.05). There were no significant differences in Fbg and PT between the two groups in each period (P>0.05). The levels of D-D were significantly increased in the two groups Id after surgery (P<0.05), and group I was higher than group II (P<0.05). The levels of D-D in the two groups 7d after surgery were significantly lower than those Id after operation (P<0.05), and group II was lower than that group I (P<0.05). The incidence of early DVT in group II was significantly lower than that in group I (P<0.05). There was no significant difference in the incidence of clinical bleeding events after prophylactic anticoagulation between the two groups (P>0.05). Conclusion: Oral high dose (10 mg) rivaroxaban after hip arthroplasty in elderly patients can effectively improve the hypercoagulable state and reduce the incidence of DVT. and will not significantly increase the clinical bleeding events, which is worth popularizing. [ABSTRACT FROM AUTHOR]