Messerschmidt Cory, Friedman Richard J
From the Department of Orthopaedics, Medical University of South Carolina, Charleston.
Arterioscler Thromb Vasc Biol. 2015 Apr;35(4):771-8. doi: 10.1161/ATVBAHA.114.303400. Epub 2015 Mar 12.
Anticoagulant medications help to reduce the risk of thromboembolic events after total hip arthroplasty and total knee arthroplasty. Traditionally, this has been accomplished with medications, such as low-molecular-weight heparin and warfarin. However, these traditional anticoagulants possess a variety of shortcomings that leave much room for improvement. A new class of oral anticoagulants is now available, and present a more convenient option for safe and efficacious thromboprophylaxis in post arthroplasty patients, particularly in the outpatient setting. This review focuses on the direct thrombin inhibitor, dabigatran, and the selective factor Xa inhibitors, rivaroxaban and apixaban, and the clinical data to date about their use in total hip arthroplasty and total knee arthroplasty patients.
抗凝药物有助于降低全髋关节置换术和全膝关节置换术后血栓栓塞事件的风险。传统上,这是通过低分子量肝素和华法林等药物来实现的。然而,这些传统抗凝剂存在多种缺点,有很大的改进空间。现在有一种新型口服抗凝剂可供使用,为关节置换术后患者,特别是门诊患者进行安全有效的血栓预防提供了更方便的选择。本综述重点关注直接凝血酶抑制剂达比加群、选择性Xa因子抑制剂利伐沙班和阿哌沙班,以及迄今为止关于它们在全髋关节置换术和全膝关节置换术患者中使用的临床数据。