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Dabigatran etexilate: pivotal trials for venous thromboembolism prophylaxis after hip or knee arthroplasty.达比加群酯：髋关节或膝关节置换术后静脉血栓栓塞预防的关键试验。
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Rivaroxaban versus enoxaparin for thromboprophylaxis after total knee arthroplasty (RECORD4): a randomised trial.利伐沙班与依诺肝素用于全膝关节置换术后血栓预防的比较（RECORD4）：一项随机试验。
Lancet. 2009 May 16;373(9676):1673-80. doi: 10.1016/S0140-6736(09)60734-0. Epub 2009 May 4.
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Metabolism and excretion of rivaroxaban, an oral, direct factor Xa inhibitor, in rats, dogs, and humans.口服直接Xa因子抑制剂利伐沙班在大鼠、犬和人类体内的代谢及排泄情况。
Drug Metab Dispos. 2009 May;37(5):1056-64. doi: 10.1124/dmd.108.025569. Epub 2009 Feb 5.
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Adherence with single-pill amlodipine/atorvastatin vs a two-pill regimen.单粒氨氯地平/阿托伐他汀与两粒药方案的依从性。
Vasc Health Risk Manag. 2008;4(3):673-81.
5
New anticoagulants.新型抗凝剂
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6
Extended duration rivaroxaban versus short-term enoxaparin for the prevention of venous thromboembolism after total hip arthroplasty: a double-blind, randomised controlled trial.延长疗程利伐沙班与短期依诺肝素预防全髋关节置换术后静脉血栓栓塞的双盲随机对照试验
Lancet. 2008 Jul 5;372(9632):31-9. doi: 10.1016/S0140-6736(08)60880-6. Epub 2008 Jun 24.
7
Rivaroxaban versus enoxaparin for thromboprophylaxis after total knee arthroplasty.利伐沙班与依诺肝素用于全膝关节置换术后血栓预防的比较。
N Engl J Med. 2008 Jun 26;358(26):2776-86. doi: 10.1056/NEJMoa076016.
8
Rivaroxaban versus enoxaparin for thromboprophylaxis after hip arthroplasty.利伐沙班与依诺肝素用于髋关节置换术后的血栓预防
N Engl J Med. 2008 Jun 26;358(26):2765-75. doi: 10.1056/NEJMoa0800374.
9
Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition).静脉血栓栓塞的预防：美国胸科医师学会循证临床实践指南（第8版）
Chest. 2008 Jun;133(6 Suppl):381S-453S. doi: 10.1378/chest.08-0656.
10
New antithrombotic drugs: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition).新型抗血栓药物：美国胸科医师学会循证临床实践指南（第8版）
Chest. 2008 Jun;133(6 Suppl):234S-256S. doi: 10.1378/chest.08-0673.

简化血栓预防措施可改善骨科手术的预后。

Simplifying thromboprophylaxis could improve outcomes in orthopaedic surgery.

作者信息

Friedman Richard J

机构信息

Department of Orthopaedic Surgery, Roper Hospital, Charleston Orthopaedic Associates, 1012 Physicians Drive, Charleston, SC 29414, USA.

出版信息

Thrombosis. 2010;2010:108049. doi: 10.1155/2010/108049. Epub 2010 Sep 13.

DOI:10.1155/2010/108049
PMID:22084657
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3211076/
Abstract

Venous thromboembolism is a serious complication after total hip or knee surgery, and there is a well-established clinical need for thromboprophylaxis. However, in a large number of cases adequate administration of thromboprophylaxis does not seem to occur after total joint arthroplasty. A major challenge in the management of thromboprophylaxis is to balance the benefits of treatment with the risks, including bleeding complications. Another potential barrier to the optimal use of thromboprophylaxis could be the inconvenience of currently available agents. Many surgeons therefore adopt a conservative approach towards thromboprophylaxis. Simplifying therapy with more convenient, efficacious, and safe anticoagulants could change attitudes to anticoagulant use and improve adherence to thromboprophylactic guidelines.

摘要

静脉血栓栓塞是全髋关节或膝关节置换术后的一种严重并发症，临床上对血栓预防有公认的需求。然而，在大量病例中，全关节置换术后似乎并未充分进行血栓预防。血栓预防管理中的一个主要挑战是在治疗益处与风险（包括出血并发症）之间取得平衡。血栓预防最佳应用的另一个潜在障碍可能是现有药物使用不便。因此，许多外科医生对血栓预防采取保守方法。使用更方便、有效且安全的抗凝剂简化治疗可能会改变对抗凝剂使用的态度，并提高对血栓预防指南的依从性。