Effect of Rivaroxaban Combined with Xuesaitong on Prevention of PTS and Postoperative Deep Vein Thrombosis Formation after Hip Replacement
LU Jun,LIU Hong-liang
Xi' an Red Cross Hospital, Xi' an 710054, China
Abstract:
Objective To investigate the effect of rivaroxaban combined with Xuesaitong in preventing PTS and postoperative deep vein thrombosis (DVT) formation after hip replacement. Methods A total of 120 patients undergoing hip arthroplasty admitted to our hospital from April 2016 to April 2018 were enrolled. The patients were divided into observation group and control group, 60 cases in each group. The patients in the control group were treated with low molecular weight heparin and thrombotherapy before operation. The patients in the observation group received preoperative rivaroxaban and rivaroxaban combined with Xuesaitong. The levels of PLT, APTT and PT were compared between the two groups at the time of admission and 4 h before surgery. The two groups of patients before the induction of anesthesia (Ta), 5 min after the start of surgery (Tb), 30 min after the start of surgery (Tc), 1 h (Td) after surgery were compared, and the levels of plasma thromboxane B2 (TXB2), 11 dehydrogenated thrombus Alkane B (DH-TXB2), thrombin-sensitive protein (TSP), beta-platelet globulin (β-TG), platelet alpha granule membrane protein (GMP-140) in patients with were compared. Serum was compared between the two groups on hospitalized (T0), immediately after surgery (T1), 3 d after surgery (T2), and 21 d after surgery (T3).The levels of CRP, homocysteine and D-dimer were compared. The venous thrombosis of the lower extremities was compared within 3 weeks after operation. The changes of whole blood viscosity, hematocrit and .brinogen before and after treatment were compared between the two groups. The incidence of adverse reactions during the treatment of the two groups of patients was counted. Results The incidence of postoperative lower extremity venous thrombosis was lower in the observation group than that in the control group (13.3% vs 40.0%, χ2=10.921, P<0.0001). In the control group, the PLT level at 4 h before surgery was lower than that at the time of admission. Compared with Tc and Td, the TXB2, DH-TXB2 and TSP in observation groups were lower than the control group, P<0.05. The levels of CRP, homocysteine and D-dimer in the two groups were higher than those before treatment (P<0.05), and gradually decreased after 3 d and 21 d after operation (P<0.05). Compared with the T0 and T1 groups, P>0.05; compared with T2 and T3, the observation group was lower than the control group (P<0.05). After treatment, the whole blood viscosity, hematocrit and .brinogen were lower in the observation group than those in the control group (P>0.05). No serious adverse reactions occurred in either group. Conclusion Ulinastatin combined with Xuesaitong can reduce hemodynamics by reducing the levels of coagulation factors TXB2, DH-TXB2 and TSP, thereby reducing postoperative CRP, homocysteine and D-dimer levels.
