低分子肝素联合阿司匹林预防髋、膝关节置换术后深静脉血栓形成的临床效果

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Abstract Objective To investigate the clinical effect of low molecular weight Heparin combined with Aspirin in preventing deep vein thrombosis (DVT) after hip and knee joint replacement. Methods A total of 600 patients with first hip and knee joint replacement who were treated in our hospital from January 2016 to December 2017 were selected as the research subjects, they were randomly divided into the low molecular weight Heparin group (200 cases), Aspirin group (200 cases), and the combined drug group (200 cases). The low molecular weight Heparin group was treated with subcutaneous injection of Enoxaparin, the Aspirin group was treated with oral Aspirin Enteric Coated Tablets, and the combined drug group was treated with subcutaneous injection of Enoxaparin and oral Aspirin Enteric Coated Tablets.The incidence of DVT and symptomatic DVT after hip and knee joint replacement among the three groups were compared. Hemoglobin, platelet count, prothrombin time (PT) and fibrinogen degradation products (FDP) among the three groups were compared before and after operation. The complications among three groups after joint replacement were compared. Results There were no significant differences of the incidence of DVT and symptomatic DVT after hip and knee joint replacement in the three groups (P>0.05). There were no significant differences in hemoglobin, platelet count, PT, and FDP among the three groups before and after operation (P>0.05). There was no symptomatic pulmonary embolism or serious bleeding event in all patients, no perioperative death event, there was no incision infection and periarticular hematoma. There was no adverse drug reactions occurred in all patients. Conclusion Aspirin, low molecular weight Heparin, and the combination of Aspirin and low molecular weight Heparin have similar effects in preventing lower limb DVT after hip and knee joint replacement. Patients should take medicine according to specific conditions.

Key words： Joint replacement Deep venous thrombosis Aspirin Low molecular weight Heparin

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[2]	中华医学会骨科学分会.中国骨科大手术静脉血栓栓塞症预防指南[J].中华骨科杂志，2016，36（2）：65-71.
[1]	Song K，Rong Z，Yao Y，et al.Metabolic syndrome and deep vein thrombosis after total knee and hip arthroplasty[J].J Arthroplasty，2016，31（6）：1322-1325.
[3]	Mistry D A，Chandratreya A，Lee PYF.A systematic review on the use of aspirin in the prevention of deep vein thrombosis in major elective lower limb orthopedic surgery：an update from the past 3 years[J].Surg J （N Y），2017，3（4）：e191-e196.
[4]	张嘉良.阿司匹林与依诺肝素钠对全膝关节置换术后静脉血栓塞症的预防作用[J].中国医学创新，2017，14（15）：51-54.
[5]	张杭，张志强，贺强，等.阿司匹林预防全膝关节置换后静脉血栓的有效及安全性[J].中国组织工程研究，2018，22（15）：2321-2326.
[6]	何炼图，汤庆，温燕杭，等.彩超检测在预防人工关节置换术后下肢深静脉血栓形成的应用[J].中华关节外科杂志（电子版），2011，5（2）：143-148.
[7]	White RH，Romano PS，Zhou H，et al.Incidence and time course of thromboembolic outcomes following total hip or knee arthroplasty[J].Arch Intern Med，1998，158（14）：1525-1531.
[8]	简长春，陈诚，戴浈浈，等.血栓弹力图评价关节置换术围手术期凝血功能改变[J].重庆医科大学学报，2015，40（5）：770-773.
[9]	乔梁，姚尧，徐志宏，等.不同季节关节置换术后下肢深静脉血栓形成发生率的差异[J].中华骨科杂志，2017，12（7）：408-415.
[10]	Wakabayashi H，Hasegawa M，Niimi R，et al.The risk factor of preoperative deep vein thrombosis in patients undergoing total knee arthroplasty[J].J Orthop Sci，2017，22（4）：698-702.
[11]	张竞，张金庆，郭盛杰，等.不同频次使用间歇式充气加压装置对预防关节置换术后下肢深静脉血栓形成的效果研究[J].中华骨与关节外科杂志，2016，9（4）：335-338.
[12]	曾荣，张曦.低分子肝素钙联合身痛逐瘀汤预防股骨骨折后深静脉血栓的临床疗效[J].中国临床医生杂志，2015，43（12）：69-72.
[13]	Snyder MA，Sympson AN，Scheuerman CM，et al.Efficacy in deep vein thrombosis prevention with extended mechanical compression device therapy and prophylactic aspirin following total knee arthroplasty：a randomized control trial[J].J Arthroplasty，2017，32（5）：1478-1482.
[14]	Goel R，Fleischman AN，Tan T，et al.Venous thromboembolic prophylaxis after simultaneous bilateral total knee arthroplasty：aspirin versus warfarin[J].Bone Joint J，2018，100-B（1 Supple A）：68-75.
[15]	Colleoni JL，Ribeiro FN，Mos PAC，et al.Venous thromboembolism prophylaxis after total knee arthroplasty（TKA）：aspirin vs.rivaroxaban[J].Rev Bras Ortop，2018，53（1）：22-27.
[16]	Park SH，Ahn JH，Park YB，et al.Incidences of deep vein thrombosis and pulmonary embolism after total knee arthroplasty using a mechanical compression device with and without low-molecular-weight heparin[J].Knee Surg Relat Res，2016，28（3）：213-218.
[17]	Abe K，Yuda S，Yasui K，et al.Soleal vein dilatation assessed by ultrasonography is an independent predictor for deep vein thrombosis after major orthopedic surgery[J].J Cardiol，2017，69（5）：756-762.
[18]	Sharma A，Bhakuni T，Biswas A，et al.Prevalence of factor v genetic variants associated with indian apcr contributing to thrombotic risk[J].Clin Appl Thromb Hemost，2017，23（6）：596-600.
[19]	Ehsani M，Imani A，Moravveji A.Prevalence of factor V leiden，MTHFR C677T and MTHFR A1298C polymorphisms in patients with deep vein thrombosis in central Iran[J].Mol Biol Rep，2018，10（4），1103-1110.
[20]	Zhu C，Jiang T，Miao Y，et al.The SNPs（-1654C/T，-1641A/G and -1476A/T）of protein C promoter are associated with susceptibility to pulmonary thromboembolism in a Chinese population[J].J Thorac Dis，2014，6（7）：943-948.
[21]	康鹏德，翁习生，刘震宇，等.中国髋、膝关节置换术加速康复——合并心血管疾病患者围术期血栓管理专家共识[J].中华骨与关节外科杂志，2016，9（3）：181-184.
[22]	Jiang Y，Du H，Liu J，et al.Aspirin combined with mechanical measures to prevent venous thromboembolism after total knee arthroplasty：a randomized controlled trial[J].Chin Med J（Engl），2014，127（12）：2201-2205.