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| Analysis of the application of Rivaroxaban after anti-fibrinolysis with Tranexamic acid in total hip arthroplasty |
| FAN Yanan1 WEN Yangyang1 LI Wenlong2 ZHU Yingjie2 LIU Youwen2 |
1.Department of Postgraduate Education for Luoyang Working, Henan University of Chinese Medicine, Henan Province, Zhengzhou 450046, China;
2.The Second Department of Hip Injury, Henan Luoyang Orthopedic Traumatological Hospital, Orthopaedic Hospital of Henan Procince, Henan Province, Luoyang 471002, China |
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Abstract Objective To evaluate the safety and efficacy of Rivaroxaban anticoagulation in the prevention of venous thromboembolism (VTE) after Tranexamic anti-fibrinolysis in total hip arthroplasty (THA) patients. Methods From March 2015 to September 2016, sixty patients with osteonecrosis of femoral head accepted THA in Henan Luoyang Orthopedic Traumatological Hospital were divided into two groups by random number table, with 30 cases in each group. The patients in group A were treated with low molecular weight heparin calcium to prevent VTE, while the patients in group B were treated with Rivaroxaban. In both groups, preoperative intravenous injection and postoperative intracavitary injection of Tranexamic acid were performed. The blood loss volume, the occurrence rates of VTE, blood transfusion and anticoagulation-related bleeding events, and blood coagulation between the two groups were recorded and compared. Results There was no significant difference in blood loss volume and transfusion rate between the two groups (P ＞ 0.05). During the follow-up, it had no symptomatic pulmonary embolism and deep venous thrombosis in the both groups, and there was no significant difference in the rate of VTE between the two groups (P ＞ 0.05). As for anticoagulant bleeding events, major bleeding events were not found in the two groups, and there was no significant difference in non-major bleeding events (P ＞ 0.05). Postoperative coagulation test showed that the prothrombin time and activated partial thromboplastin time in both groups were longer in the safety range than in the preoperative period, and there was no statistically significant difference between groups at the same time (P > 0.05). Conclusion The use of low molecular weight heparin calcium or rivaroxaban in the prevention of venous thromboembolism in patients with THA are both safe and effective. However low molecular weight heparin calcium requires subcutaneous injection and dose adjustment. In contrast，patients in Rivaroxaban are more receptive and compliant, which can be ensured that the postoperative drug prevention VTE time and improve surgical safety.
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