摘要
目的比较利伐沙班、低分子肝素预防老年髋部骨折患者深静脉血栓(DVT)的疗效和安全性。方法回顾性分析中国人民解放军总医院骨科2010年1月-2012年12月收治的702例老年髋部骨折患者的临床资料,按DVT预防方式分为利伐沙班组(155例)和低分子肝素组(547例),比较两组患者术后1个月内血栓、出血事件发生率。结果在术后1个月随访期间,利伐沙班组的总DVT发生率为3.2%(5/155),显著低于低分子肝素组的8.8%(48/547,P<0.05)。利伐沙班和低分子肝素组的总出血事件发生率分别为4.5%(7/155)、4.8%(26/547),两组间差异无统计学意义(P>0.05);利伐沙班组的术中出血量显著高于低分子肝素组(P<0.01),但两组间术后引流量和输血量的差异均无统计学意义(P值均>0.05)。结论与低分子肝素相比,利伐沙班应用于老年髋部骨折患者,在降低DVT发生率的同时不增加出血风险,可用于老年髋部骨折围术期DVT预防。
Objective To compare the safety and efficacy between rivaroxaban and low molecular weight heparin （LMWH） in preventing deep vein thrombosis （DVT） in elderly hip fracture patients. Methods We performed a retrospective cohort study in 702 consecutive patients with hip fracture treated in our hospital between January 2010 and December 2012. All the patients were divided into rivaroxaban group （155 cases） and LMWH group （547 cases） according to different DVT prevention. The incidences of venous thromboembolism （VTE） and bleeding were compared between the two groups. Results After one-month follow-up, VTE incidence in rivaroxaban group （3.2%, 5/155） was significantly lower than that in LMWH group （8.8%, 48/547, both P〈0.05）. The incidence of bleeding was 4.5% （7/155） in rivaroxaban group and 4.8% （26/547） in LMWH group. The major and minor bleeding events showed no significant differences between the two groups （P 〉 0.05）. Although the mean blood loss during surgery in rivaroxaban group was significantly more than that in LMWH group （P〈0.01）, there were no significant differences in the drainage or transfusion volume between two groups （both P〉0.05）. Conclusion Compared with LMWH, Rivaroxaban can reduce the incidence of VTE without increasing bleeding in elderly hip fracture patients. Therefore, rivaroxaban can be used for preventing perioperative DVT in elderly patients with hip fractures.
出处
《上海医学》
CAS
CSCD
北大核心
2014年第1期35-38,共4页
Shanghai Medical Journal
关键词
深静脉血栓
血栓预防
利伐沙班
低分子肝素
大出血事件
Deep vein thrombosis Venous thromboembolism prophylaxis Rivaroxaban
Low molecularweight heparin Major bleeding events
