阿司匹林预防髋关节置换术后深静脉血栓形成

doi:10.3877/cma.j.issn.1674-134X.2019.05.002

目的

评价阿司匹林用于髋关节置换术后深静脉血栓预防的疗效与安全性。

方法

前瞻性纳入60岁以上髋关节置换术患者，排除凝血异常者，共124例，对研究者设盲，按抗凝药物不同以随机数字表分为4组，分别为对照组、阿司匹林组、序贯治疗组、联合治疗组，每组31例，比较术后5周深静脉血栓、出血事件发生率，比较各组药物费用。计量资料比较采用单因素方差分析，计数资料采用卡方检验。

结果

术后5周总深静脉血栓发生率为3.2%，各组间深静脉血栓发生率相当，差异没有统计学意义(χ²＝2.067，P>0.05)，各组未发生严重出血事件，阿司匹林组抗凝药物费用显著低于其他3组(t＝16.472，P<0.001)。

结论

阿司匹林单独用于髋关节置换术后深静脉血栓预防安全有效。

关键词: 阿司匹林, 关节成形术，置换，髋, 静脉血栓形成, 抗凝药

Objective

To evaluate the efficacy and safety of aspirin as a prophylaxis agent against venous thromboembolism following hip arthroplasty.

Methods

According to inclusion (older than 60 years) and exclusion criteria (blood coagulation disurbance), 124 cases of hip arthroplasty were recruited prospectively and divided into four groups by random number table as control group, aspirin group, sequential therapy group and combined therapy group. Each group contained 31 cases. The rates of deep venous thrombosis, bleeding risk and fee of antithrombotic agent were compared among groups five weeks postoperatively. Analysis of variance (ANOVA) was used to measurement data, and chi-square test was used to enumeration data.

Results

The total rate of deep venous thrombosis was 3.2% and there wase no significant difference among four groups and between each two groups (χ²=2.067, P>0.05). No serious bleeding affair happened. The cost of antithrombotic agent of the aspirin group was significantly lower than other groups(t=16.472, P<0.01).

Conclusion

Aspirin is effective and safe enough to prevent deep venous thrombosis following hip arthroplasty.

Key words: Aspirin, Arthroplasty, replacement, hip, Venous thrombosis, Anticoagulants

表1 各组一般资料

分组	例数	年龄[岁，(±s)]	女性(例)	Caprini评分(±s)	BMI[kg/m²，(±s)]	全髋置换(例)
对照组	31	66.9±2.2	14	7.1±0.1	24.2±1.6	27
阿司匹林组	31	67.8 ±2.4	15	7.2±0.1	25.5±1.6	26
序贯治疗组	31	68.1±2.1	14	7.2±0.1	25.9±1.8	26
联合预防组	31	67.5±2.4	16	7.1±0.1	25.4±1.3	28
统计值	?	t＝1.684	χ²＝1.232	t＝0.844	t＝1.876	χ²＝0.579
P值	?	>0.05	>0.05	>0.05	>0.05	>0.05

表1 各组一般资料

分组	例数	年龄[岁，(±s)]	女性(例)	Caprini评分(±s)	BMI[kg/m²，(±s)]	全髋置换(例)
对照组	31	66.9±2.2	14	7.1±0.1	24.2±1.6	27
阿司匹林组	31	67.8 ±2.4	15	7.2±0.1	25.5±1.6	26
序贯治疗组	31	68.1±2.1	14	7.2±0.1	25.9±1.8	26
联合预防组	31	67.5±2.4	16	7.1±0.1	25.4±1.3	28
统计值	?	t＝1.684	χ²＝1.232	t＝0.844	t＝1.876	χ²＝0.579
P值	?	>0.05	>0.05	>0.05	>0.05	>0.05

表2 各组发生静脉血栓例数(例)

分组	例数	静脉血栓总例数	腘静脉以上血栓例数
对照组	31	3	1
阿司匹林组	31	4	1
序贯治疗组	31	4	2
联合预防组	31	5	0
χ²值	?	0.574	2.067
P值	?	>0.05	>0.05^*

表2 各组发生静脉血栓例数(例)

分组	例数	静脉血栓总例数	腘静脉以上血栓例数
对照组	31	3	1
阿司匹林组	31	4	1
序贯治疗组	31	4	2
联合预防组	31	5	0
χ²值	?	0.574	2.067
P值	?	>0.05	>0.05^*

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Prevention of deep venous thrombosis after hip arthroplasty with aspirin

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Prevention of deep venous thrombosis after hip arthroplasty with aspirin