Division of Hospital Medicine, Department of Medicine, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, USA.
J Thromb Thrombolysis. 2012 Nov;34(4):518-25. doi: 10.1007/s11239-012-0751-5.
Patients undergoing total knee and total hip replacement (THR/TKR) surgery are at high risk of venous thromboembolism (VTE), and routine thromboprophylaxis is recommended after these procedures. However, current thromboprophylaxis may require daily injections, careful anticoagulation monitoring, and dietary restrictions, which can lead to poor patient compliance and suboptimal outcomes. Therefore, there is an unmet need for simpler medication options. Newer oral anticoagulants have improved efficacy over standard treatments, with convenient dosing regimens, more predictable pharmacologic profiles that reduce the need for anticoagulation monitoring, and fewer drug or food interactions. These drugs have the potential to simplify anticoagulation after THR or TKR surgery, which may lead to improved adherence, thus lowering the incidence of VTE and associated complications after surgery.
接受全膝关节和全髋关节置换术（THR/TKR）的患者存在发生静脉血栓栓塞症（VTE）的高风险，这些手术后建议常规进行血栓预防。然而，目前的血栓预防可能需要每天注射、仔细的抗凝监测和饮食限制，这可能导致患者依从性差和治疗效果不佳。因此，存在对更简单药物选择的未满足需求。新型口服抗凝剂在疗效上优于标准治疗，具有方便的给药方案、更可预测的药理学特征，减少了抗凝监测的需求，以及更少的药物或食物相互作用。这些药物有可能简化 THR 或 TKR 手术后的抗凝治疗，从而提高依从性，从而降低手术后 VTE 及相关并发症的发生率。
