论文部分内容阅读
目的：比较阿司匹林和低分子肝素预防全膝关节置换术（total knee arthroplasty，TKA）后下肢深静脉血栓形成（deep vein thrombosis，DVT）的疗效和安全性。方法对2015年2月~2015年8月于北京积水潭医院矫形骨科初次行单侧TKA的120例骨关节炎患者随机分为两组，术后12 h，阿司匹林组给予口服阿司匹林（拜阿司匹林）150 mg/d，低分子肝素组给予皮下注射低分子肝素钠（齐征）2500 AxaIU（0.2 ml）／d，两组均应用14 d。对两组DVT发生率、显性及隐性失血量、血红蛋白下降量、血肿发生率及感染发生率进行比较，评价阿司匹林预防TKA术后DVT的疗效及安全性。结果阿司匹林组，出现有症状性DVT 4例（6.7%），低分子肝素组术后出现有症状性DVT 3例（5.0%），两组均未出现疑似或者确诊的肺栓塞。两组比较无统计学意义（P值为0.136）。阿司匹林组出血量、血红蛋白下降量、血肿发生率、感染发生率为（331.2±41.5）ml、（19.2±6.0）g/L、1例（1.6％）、0例（0％），低分子肝素组为（452.1±53.3）ml、（29.2±8.6）g/L、3例（5.0％）、1例（0.17％），两组之间无统计学差异（P值分别是0.226、0.421、0.325、0.268）。结论阿司匹林与低分子肝素相比抗凝效果和术后失血量及出血并发症无差异，但阿司匹林药剂制备成熟，服用方便，价格便宜，对栓塞性疾病的预防作用具有一定优势，可作为全膝关节置换术后多模式抗凝治疗的一部分，安全有效。“,”Objective To compare the efficacy and safety of aspirin in prophylaxis of deep venous thrombosis of lower limbs after total knee arthroplasty. Methods From February 2015 to August 2015,120 patients met with our inclusion criteria.All the patients were divided into 2 groups randomly. One group received aspirin enteric-coated tablets 150mg/day since the first day after operation till discharge14 days, and other group received subcutaneous injection of low molecular weight heparin (LMWH) with 2500 Axa IU once daily for 14 days. Estimate the efficacy and safety of aspirin in prevention of DVT of lower limbs after total knee arthroplsaty. Results 4 patients (6.7%) were diagnosed with deep venous thrombosis in group Aspirin. In group LMWH ,3patients (5.0%)had DVT. There were no symptomatic and suspicious pulmonary embolism in two groups. There were no statistic significances between the two groups in all these aspects,such as the quantity of bleeding、decrease of hemoglobin、hematoma rate and infection rate. Conclusion Contrast Aspirin and LMWH, there is no difference in venous thromboemlolism prophylaxis、blood lost and hemorrhage complication postoperation. But Aspirin is cheap, drug-nature stable, administered orally, well tolerated, as a partion of multimodality anticoagulant therapy after total knee arthroplasty.