首页|全膝置换围手术期三种抗凝方法比较

全膝置换围手术期三种抗凝方法比较

Comparison of perioperative results of three anticoagulant methods in total knee replacement

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[目的]比较全膝关节置换术(total knee arthroplasty,TKA)围手术期三种抗凝治疗在西藏患者的效果.[方法]2021年1月—2021年7月,60例行TKA的西藏患者纳入本研究,采用随机数字表法随机分为三组,A组20例使用阿司匹林25 mg/d;B组20例使用阿司匹林100mg/d;C组20例使用低分子肝素钙0.4ml/d抗凝.评价三组临床和彩超检查结果.[结果]三组手术时间、术中出血量、总失血量的差异均无统计学意义(P>0.05).与1d相比,术后3、7d三组的VAS评分均显著减少(P<0.05),ROM均显著增加(P<0.05),但是髌上周径无显著变化(P>0.05).相应时间点,三组间VAS评分、ROM、髌上周径的差异均无统计学意义(P>0.05).超声检查方面,术后三组血栓发生率的差异无统计学意义(5%vs5%vs10%,P>0.05).[结论]本研究中TKA术后使用25 mg、100 mg阿司匹林和低分子肝素钙的术后早期血栓发生率无明显差异.
[Objective]To compare the early outcomes of three kinds of anticoagulation treatment during perioperative period of total knee arthroplasty(TKA)in Tibetan patients.[Methods]From January 2021 to July 2021,60 Tibetan patients who were undergoing TKA were included in this study and randomly divided into three groups by random number table method.Twenty patients in group A received as-pirin 25 mg/day;20 patients in group B received aspirin 100 mg/d;20 patients in group C were treated with low molecular weight heparin cal-cium 0.4ml/d for anticoagulation.The results of clinical and color ultrasonography were evaluated.[Results]There were no significant differ-ences in operation time,intraoperative blood loss and total blood loss among the three groups(P>0.05).Compared with those 1 day postopera-tively,VAS scores in the 3 groups were significantly decreased 3 days and 7 days postoperative(P<0.05),the ROM was significantly in-creased(P<0.05),with suprapatellar circumference remained unchanged(P>0.05).At corresponding time points,there were no significant differences in VAS score,ROM and suprapatellar circumference among the three groups(P>0.05).In terms of ultrasonography,there was no significant difference in the incidence of thrombus among the three groups(5%vs 5%vs 10%,P>0.05).[Conclusion]In this study,there was no significant difference in the incidence of early postoperative thrombosis among the 25 mg aspirin,100mg aspirin and low molecular weight heparin calcium after TKA.

total knee arthroplastyaspirinlow molecular weight heparindeep vein thrombosis

邓立庆、万伦、黄继、何芳、黄奇

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西藏自治区人民政府驻成都办事处医院骨科,四川成都 610041

全膝关节置换 阿司匹林 低分子肝素 深静脉血栓

四川省医学科研课题计划项目四川省医学会骨科(尚安通)专项科研课题项目四川省医学青年创新科研课题项目

S220462019SAT02Q17078

2024

中国矫形外科杂志
中国残疾人康复协会 中国人民解放军第八十八医院

中国矫形外科杂志

CSTPCD北大核心
影响因子:1.521
ISSN:1005-8478
年,卷(期):2024.32(15)