| 利伐沙班对全髋关节置换术隐性出血影响的病例对照研究 |
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投稿时间：2013-01-28
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| 作者 | Author | 单位 | Address | E-Mail |
| 李军 |
LI Jun |
安徽医科大学第二附属医院骨科, 安徽 合肥 230601 |
Department of Orthopaedics, the Second Hospital Affiliated to Anhui Medical University, Hefei 230601, Anhui, China |
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| 荆珏华 |
JING Jue-hua |
安徽医科大学第二附属医院骨科, 安徽 合肥 230601 |
Department of Orthopaedics, the Second Hospital Affiliated to Anhui Medical University, Hefei 230601, Anhui, China |
jjhhu@sina.com |
| 史占军 |
SHI Zhan-jun |
南方医科大学南方医院关节与骨病外科, 广东 广州 510515 |
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| 周云 |
ZHOU Yun |
安徽医科大学第二附属医院骨科, 安徽 合肥 230601 |
Department of Orthopaedics, the Second Hospital Affiliated to Anhui Medical University, Hefei 230601, Anhui, China |
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| 期刊信息：《中国骨伤》2014年，第27卷，第1期，第34-37页 |
| DOI：10.3969/j.issn.1003-0034.2014.01.009 |
| 基金项目: |
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中文摘要:
目的：探讨利伐沙班对全髋关节置换术隐性失血是否造成影响。
方法：将2009年10月至2012年5月初次行全髋关节置换术的88例股骨头坏死患者，分为两组，分别采用利伐沙班和安慰剂预防治疗静脉血栓。利伐沙班组44例，对照组44例。利伐沙班组男25例，女19例，平均年龄（58.48±15.19）岁；对照组男24例，女20例，平均年龄（61.11±13.54）岁。两组患者术前准备、术中及术后处理均一致。利伐沙班组从术后第1天开始每日口服利伐沙班10 mg，连用14 d;对照组于相同时间点口服安慰剂。术前及术后第3天行血常规检查，根据公式计算理论失血总量和隐性失血量。
结果：利伐沙班组实际总失血量（1 509.56±325.23） ml，隐性失血量（581.47±215.01） ml，占总量的（37.88±10.42）%;对照组实际总失血量平均（1 262.30±397.95） ml，隐性失血量（395.59±197.33） ml，占总量的（30.62±10.20）%.经统计学分析，两组显性失血量差异无统计学意义，利伐沙班组实际总失血量和隐性失血量均大于对照组，利伐沙班组隐性失血量占实际总失血量的比例也高于对照组。术后35 d内利伐沙班组发生出血事件4例，对照组发生1例，但差异无统计学意义（χ2=1.908，P=0.167）.
结论：利伐沙班增加了全髋关节置换术总体出血风险，尤其是隐性出血风险，临床应用时要注意出血。 |
| 【关键词】关节成形术,置换,髋 失血,手术 抗凝药 病例对照研究 |
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| Case-control study on effect of Rivaroxaban on the risk of hidden bleeding after total hip arthroplasty |
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ABSTRACT
Objective: To investigate the risk of hidden blood loss about applying rivaroxaban after total hip arthroplasty.
Methods: From October 2009 to May 2012,88 patients with femoral head necrosis were treated with primary total hip arthroplasty. All the patients were divided into Rivaroxaban group（44 cases）and control group（44 cases）. There were 25 males and 19 females in the Rivaroxaban group,with an average age of（58.48±15.19） years old;in the control group,24 patients were male and 20 patients were female,with an average age of（61.11±13.54） years old. The patients in the Rivaroxaban group took Rivaroxaban orally from the first day after operation with a dose of 10 mg each day,and treatment course was 14 days. The patients in the control group took placebo orally at the same time. Dominant blood loss and transfusion were recorded,blood routine examinations were taken before operation and at 3 days after operation. The total blood loss and hidden blood loss were calculated according to the formula.
Results: The mean total blood loss was（1 509.56±325.23） ml and the hidden blood loss was（581.47±215.01） ml,accounting for（37.88±10.42）% in the Rivaroxaban group. The mean total blood loss was（1 262.30±397.95） ml and the hidden blood loss was（395.59±197.33） ml,accounting for（30.62±10.20）% in the control group. The total blood loss,hidden blood loss and transfusion in the Rivaroxaban group was significantly more than those in control group,but there was no significant difference on dominant blood loss between two groups.
Conclusion: Rivaroxaban increased the overall bleeding risk of total hip arthroplasty,especially hidden bleeding risk,which should be careful used. |
| KEY WORDS Arthroplasty,replacement,hip Blood loss,surgical Anticoagulants Case-control studies |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 李军,荆珏华,史占军,周云.利伐沙班对全髋关节置换术隐性出血影响的病例对照研究[J].中国骨伤,2014,27(1):34~37 |
| 英文格式: | LI Jun,JING Jue-hua,SHI Zhan-jun,ZHOU Yun.Case-control study on effect of Rivaroxaban on the risk of hidden bleeding after total hip arthroplasty[J].zhongguo gu shang / China J Orthop Trauma ,2014,27(1):34~37 |
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