Haibier Abuduwupuer, Aierxiding Shalayiding, Yusufu Alimujiang, Lin Hang
Sixth Affiliated Hospital of Xinjiang Medical University, Orthopaedic Hospital of Xinjiang Uygur Autonomous Region, No.39 Wuxing Road, Urumqi, People's Republic of China.
Xinjiang Medical University, Xinjiang Uygur Autonomous Region, Urumqi, People's Republic of China.
BMC Musculoskelet Disord. 2025 Sep 1;26(1):826. doi: 10.1186/s12891-025-08605-z.
Low-molecular-weight heparin (LMWH) and nadroparin calcium are commonly used to prevent deep vein thrombosis (DVT) following joint replacement surgery. In this study, we compared the effects of tranexamic acid combined with either LMWH or nadroparin calcium in preventing DVT after joint replacement surgery.
A retrospective analysis was conducted on patients who underwent unilateral THA/TKA at the Sixth Affiliated Hospital of Xinjiang Medical University from September 2021 to June 2023. Patients were divided into two groups based on the anticoagulant used: Tranexamic Acid + Low-Molecular-Weight Heparin group (n = 80) and Tranexamic Acid + Nadroparin Calcium group (n = 85), both treated for 2 weeks. The perioperative indicators [blood loss, hospital stay, operation time, transfusion rate, transfusion volume, and total hospitalization cost], complications DVT, muscle compartment vein thrombosis (MCVT), incision infection, pulmonary thromboembolism, and postoperative hematoma], coagulation indicators [D-dimer, prothrombin activity, international normalized ratio, and fibrinogen], hematological parameters [platelets, hemoglobin, hematocrit], and inflammatory factors [procalcitonin (PCT), interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor (TNF-α)] were compared between the two groups.
The preoperative indicators of both groups were statistically indistinguishable (P > 0.05). Comparisons of intraoperative blood loss, overt blood loss, covert blood loss, total blood loss, hospital stay duration, operation time, transfusion rate, and transfusion volume showed no significant differences between the groups (P > 0.05). The TXA + LMWH group exhibited significantly lower D-dimer, PT activity, international normalized ratio, and fibrinogen levels on postoperative days 1 and 5 compared to the TXA + Nadroparine group, with significant differences observed (P < 0.05). No significant differences between the two groups were found in platelet count, hemoglobin, hematocrit, PCT, IL-6, IL-8, and TNF-α levels on postoperative days 1 and 5 (P > 0.05). The total hospitalization costs in the TXA + LMWH group were significantly lower than those in the TXA + Nadroparine group, with a significant difference (P < 0.05).
This study found that the clinical efficacy and safety of the TXA + Nadroparine and TXA + LMWH groups were basically the same after joint replacement surgery. However, the TXA + LMWH group demonstrated better prevention of thrombosis and significantly lower overall hospitalization costs compared to the TXA + Nadroparine group.
低分子量肝素（LMWH）和那屈肝素钙常用于预防关节置换术后深静脉血栓形成（DVT）。在本研究中，我们比较了氨甲环酸联合LMWH或那屈肝素钙在预防关节置换术后DVT方面的效果。
对2021年9月至2023年6月在新疆医科大学第六附属医院接受单侧全髋关节置换术（THA）/全膝关节置换术（TKA）的患者进行回顾性分析。根据使用的抗凝剂将患者分为两组：氨甲环酸+低分子量肝素组（n = 80）和氨甲环酸+那屈肝素钙组（n = 85），两组均治疗2周。比较两组的围手术期指标[失血量、住院时间、手术时间、输血率、输血量和总住院费用]、并发症DVT、肌间室静脉血栓形成（MCVT）、切口感染、肺血栓栓塞和术后血肿]、凝血指标[D-二聚体、凝血酶原活性、国际标准化比值和纤维蛋白原]、血液学参数[血小板、血红蛋白、血细胞比容]以及炎症因子[降钙素原（PCT）、白细胞介素-6（IL-6）、白细胞介素-8（IL-8）和肿瘤坏死因子（TNF-α）]。
两组术前指标在统计学上无差异（P>0.05）。术中失血量、显性失血量、隐性失血量、总失血量、住院时间、手术时间、输血率和输血量的比较显示两组之间无显著差异（P>0.05）。与氨甲环酸+那屈肝素组相比，氨甲环酸+低分子量肝素组在术后第1天和第5天的D-二聚体、PT活性、国际标准化比值和纤维蛋白原水平显著更低，差异有统计学意义（P<0.05）。两组在术后第1天和第5天的血小板计数、血红蛋白、血细胞比容、PCT、IL-6、IL-8和TNF-α水平无显著差异（P>0.05）。氨甲环酸+低分子量肝素组的总住院费用显著低于氨甲环酸+那屈肝素组，差异有统计学意义（P<0.05）。
本研究发现关节置换术后氨甲环酸+那屈肝素组和氨甲环酸+低分子量肝素组的临床疗效和安全性基本相同。然而，与氨甲环酸+那屈肝素组相比，氨甲环酸+低分子量肝素组在预防血栓形成方面表现更好，且总住院费用显著更低。
