Friedman Richard J
Department of Orthopaedic Surgery, Roper Hospital, and Department of Orthopaedic Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
Orthopedics. 2009 Dec;32(12 Suppl):79-84. doi: 10.3928/01477447-20091103-53.
Patients undergoing total hip or knee arthroplasty are at increased risk of venous thromboembolism (VTE). The long-term sequelae of VTE, such as post-thrombotic syndrome or pulmonary hypertension, can be debilitating with severe morbidity. Conventional anticoagulants have several short-comings: for example, warfarin requires regular coagulation monitoring and low-molecular-weight heparins are inconvenient to use because they require subcutaneous administration. The development of new anticoagulants has focused on 2 classes of compounds: direct thrombin inhibitors and direct factor Xa inhibitors. These new oral agents have shown efficacy in large randomized clinical trials and offer new, more convenient options for anticoagulation.
接受全髋关节或膝关节置换术的患者发生静脉血栓栓塞（VTE）的风险增加。VTE的长期后遗症，如血栓后综合征或肺动脉高压，可能会使人衰弱并导致严重的发病率。传统抗凝剂有几个缺点：例如，华法林需要定期进行凝血监测，而低分子量肝素使用不便，因为它们需要皮下注射。新型抗凝剂的研发集中在两类化合物上：直接凝血酶抑制剂和直接Xa因子抑制剂。这些新型口服药物在大型随机临床试验中已显示出疗效，并为抗凝提供了新的、更方便的选择。
