Zhang Yi-Min, Liu Jian-Yong, Sun Xue-Dong, Zhang Miao, Liu Xiao-Guang, Chen Xiu-Li
Department of Joint Surgery, Weifang People's Hospital, Weifang, P.R. China.
Medicine (Baltimore). 2018 Oct;97(40):e12630. doi: 10.1097/MD.0000000000012630.
Osteoarthritis (OA) is the third most common diagnosis made by general practitioners in older patients. The purpose of the current study is to investigate effects rivaroxaban had on both hidden blood loss and blood transfusion rate (BTR) in patients with knee OA (KOA) after going through a total knee replacement (TKR).Between the time periods of December 2011 up until January 2015, a total of 235 patients underwent TKR and were selected to be assigned to either the rivaroxaban or nonanticoagulant groups. Coagulation function indexes before surgery and following administration of rivaroxaban, total blood loss, hidden blood loss, dominant blood loss, blood transfusion volume, hemoglobin reduction, degree of postoperative pain (visual analogue scale), the degree of knee swelling, and range of motion following surgery were all recorded. Hospital for special surgery (HSS) scores offered an objective evaluation for the knee joint functions before surgery at the intervals of 2 weeks and after surgery at intervals of 3 months, 6 months, 12 months, and 24 months.Patients in the rivaroxaban group had shown a higher hidden blood loss, as well as a higher BTR, compared to those involved in the nonanticoagulant group. BTR was found to have been 49.59% in the rivaroxaban group, and 35.09% for the nonanticoagulant group. Patients in the rivaroxaban group had lower degrees of knee swelling than those involved in the nonanticoagulant group. There was no deep vein thrombosis (DVT) detected in the rivaroxaban group, whereas 5 DVT cases were detected in the nonanticoagulant group. In the rivaroxaban group, the HSS scores of the knee joint functions were remarkably higher at the 2-week mark in succession to the surgery than those involved with the nonanticoagulant group.This overall data demonstrated that KOA patients after TKR had presented with a higher hidden blood loss, BRT, and lower swelling degrees of the knee joint after being treated by the rivaroxaban.
骨关节炎（OA）是老年患者中全科医生诊断出的第三大常见病症。本研究的目的是调查利伐沙班对接受全膝关节置换术（TKR）的膝骨关节炎（KOA）患者隐性失血和输血率（BTR）的影响。在2011年12月至2015年1月期间，共有235例患者接受了TKR，并被选入利伐沙班组或非抗凝组。记录手术前和服用利伐沙班后的凝血功能指标、总失血量、隐性失血量、显性失血量、输血量、血红蛋白降低情况、术后疼痛程度（视觉模拟评分）、膝关节肿胀程度以及术后活动范围。特种外科医院（HSS）评分分别在术前2周以及术后3个月、6个月、12个月和24个月对膝关节功能进行客观评估。与非抗凝组相比，利伐沙班组患者的隐性失血量和BTR更高。利伐沙班组的BTR为49.59%，非抗凝组为35.09%。利伐沙班组患者的膝关节肿胀程度低于非抗凝组。利伐沙班组未检测到深静脉血栓形成（DVT），而非抗凝组检测到5例DVT病例。在利伐沙班组中，术后2周膝关节功能的HSS评分明显高于非抗凝组。总体数据表明，TKR术后的KOA患者在接受利伐沙班治疗后，隐性失血量、BRT较高，膝关节肿胀程度较低。
