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全膝关节置换术后(TKA)的静脉血栓栓塞预防:阿司匹林与利伐沙班。

Venous thromboembolism prophylaxis after total knee arthroplasty (TKA): aspirin rivaroxaban.

作者信息

Colleoni Jose Luiz, Ribeiro Fernando Noel, Mos Paulo Augusto Castro, Reis João Paulo, Oliveira Henrique Rosa de, Miura Beatriz Kawata

机构信息

Hospital Mario Covas, Faculdade de Medicina do ABC, Santo André, SP, Brazil.

出版信息

Rev Bras Ortop. 2017 Dec 6;53(1):22-27. doi: 10.1016/j.rboe.2017.11.007. eCollection 2018 Jan-Feb.

Abstract

OBJECTIVES

To compare the efficacy and safety of aspirin and rivaroxaban in preventing venous thromboembolism (VTE) after total knee arthroplasty (TKA).

METHODS

Thirty-two patients with osteoarthritis of the knee and knee arthroplasty indication were selected. The operated patients were randomized into two groups (A and B). Group A received 300 mg of acetylsalicylic acid (aspirin) and Group B received 10 mg of rivaroxaban daily for 14 days. Follow-up was performed weekly for four weeks and evaluated the presence of signs and symptoms of DVT, the healing of the surgical wound, and possible local complications such as hematoma, and superficial or deep infection that required surgical approach.

RESULTS

It was verified that there were no differences between groups (rivaroxaban and aspirin) regarding gender, age, and ( > 0.05). After using the general linear model (GLM) test, it was found that there was a decrease in Hb and Ht levels, preoperatively and at one, three, seven, and 14 days (Hb:  = 1.334 × 10; Ht:  = 1.362 × 10). However, they did not differ as to the type of medication (Hb:  = 0.152; Ht:  = 0.661). There were no identifiable differences in local complications, systemic complications, deep vein thrombosis (DVT), readmission to hospital, reoperation, or death ( > 0.05) between groups (rivaroxaban and aspirin).

CONCLUSIONS

Both aspirin and rivaroxaban can be considered useful among drugs available VTE the prevention after TKA.

摘要

目的

比较阿司匹林和利伐沙班在预防全膝关节置换术(TKA)后静脉血栓栓塞症(VTE)方面的疗效和安全性。

方法

选取32例患有膝关节骨关节炎且有膝关节置换术指征的患者。将接受手术的患者随机分为两组(A组和B组)。A组患者每天服用300毫克乙酰水杨酸(阿司匹林),B组患者每天服用10毫克利伐沙班,持续14天。每周进行一次为期四周的随访,评估深静脉血栓形成的体征和症状、手术伤口的愈合情况以及可能的局部并发症,如血肿、需要手术处理的浅表或深部感染。

结果

证实两组(利伐沙班和阿司匹林组)在性别、年龄方面无差异(>0.05)。使用一般线性模型(GLM)测试后发现,术前以及术后第1天、第3天、第7天和第14天,血红蛋白(Hb)和血细胞比容(Ht)水平有所下降(Hb:=1.334×10;Ht:=1.362×10)。然而,在药物类型方面它们并无差异(Hb:=0.152;Ht:=0.661)。两组(利伐沙班和阿司匹林组)在局部并发症、全身并发症、深静脉血栓形成(DVT)、再次入院、再次手术或死亡方面无明显差异(>0.05)。

结论

阿司匹林和利伐沙班均可被视为在TKA后预防VTE的可用药物中有效的药物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc23/5771791/c2907df41d81/gr1.jpg

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