替格瑞洛预防老年全髋关节置换术后深静脉血栓形成的效果及价值

摘要

目的 探讨替格瑞洛预防老年髋关节置换患者术后深静脉血栓形成的价值.方法 前瞻性收集我院2015年1月至2016年6月收治的全髋关节置换患者96例,将患者随机分为观察组和对照组.观察组采用替格瑞洛预防术后深静脉血栓形成,对照组采用低分子肝素钠.观察两组患者的深静脉血栓发生率、肺栓塞率、D-二聚体、患肢周径、术后引流量、引流时间、血肿、淤斑、切口感染、肺部感染、术中出血量、手术时间.结果 观察组患者深静脉血栓发生率低于对照组(2.08% vs.16.67%,P=0.014).两组患者术前D-二聚体和患肢周径比较差异无统计学意义(P>0.05).观察组患者术后3、7 d D-二聚体和患肢周径小于对照组(P0.05).结论 替格瑞洛显著降低老年全髋关节置换术后深静脉血栓率,值得临床推广应用.%Objective To explore the value of ticagrelor in preventing deep venous thrombosis in elderly patients after total hip replacement surgery.Methods Totally 96 patients with total hip replacement in our hospital from January 2015 to June 2016 were selected and randomly divided into observation group and control group.The patients in observation group received ticagrelor for prevention of postoperative deep venous thrombosis and control group was given low molecular weight heparin.The incidence rate of deep venous thrombosis and pulmonary embolism,D-two dimers,limb circumference,postoperative drainage,drainage time,hematoma,ecchymosis,incision infection,pulmonary infection,bleeding volume and operation time were recorded.Results The incidence of deep venous thrombosis in observation group was lower than that of control group (2.08% vs.16.67%,P=0.014).No significant difference was observed in D-two dimer and limb circumference between the two groups before surgery (P>0.05),while there were significant differences at 3 d and 7 d after surgery (P>0.05).No significant difference was found in the amount of bleeding,operation time,postoperative drainage,drainage time,postoperative pulmonary embolism,ecchymosis,hematoma,wound infection and lung infection between the two groups (P>0.05).Conclusion Ticagrelor can decrease the incidence of deep venous thrombosis after total hip replacement in elderly patients,which is worthy of further promotion