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首页> 外文期刊>Open Journal of Urology >The Clinical Characteristics of Combined Deep Vein Thrombosis Prophylaxis of Rivaroxaban and Mechanical Therapy after Total Knee Replacement Arthroplasty
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The Clinical Characteristics of Combined Deep Vein Thrombosis Prophylaxis of Rivaroxaban and Mechanical Therapy after Total Knee Replacement Arthroplasty

机译：利伐沙班联合深静脉血栓预防和全膝关节置换术后机械治疗的临床特征

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Purpose: To investigate the clinical characteristics of combined prophylaxis of rivaroxaban (Xarelto?) and mechanical therapy (foot sole pump, antiembolism stocking) after total knee replacement arthroplasty, for prevention of deep vein thrombosis (DVT). Materials and Methods: The subjects of this study were 110 patients who underwent total knee replacement arthroplasty (TKA) between November 2011 and May 2012, and were prospectively evaluated. They consisted of 13 men (11.8%) and 97 women (88.2%) with the mean age of 68.7 years (±7.9). All of the patients received 10 mg of rivaroxaban once daily for 14 days from Day 1 postoperatively, and used an intermittent pneumatic compression (IPC) pump and compression stockings immediately after the operation. To determine the presence of postoperative DVT, clinical symptoms examination, D-dimer test, color Doppler ultrasound imaging were performed to analyze the risk factors of DVT events. Results: There were a total of 13 patients (11.8%) with DVT in the distal lower limbs among the entire 110 patients. At Day 4 after the operation, a statistically significant difference was seen only in femoral swelling of several clinical symptoms between DVT group and non-DVT group (p = 0.043). D-dimer tests showed no statistically significant difference between the two groups, however with the boundary value of 0.3 mg/L, diagnostic sensitivity, specificity, positive predictability and negative predictability were equivalent to 100%, 8.2%, 12.7% and 100%, respectively. There was no significant difference between the two groups in terms of well-known risk factors including age, gender, obesity, hypertension, diabetes, smoking, and anesthesia method, and no case of pulmonary embolism was observed. Conclusion: A combination of pharmacological therapy (rivaroxaban, Xarelto?) and mechanical therapy (foot sole pump system) after TKA is considered effective for DVT prevention.
机译：目的：探讨在全膝关节置换术后，利伐沙班（Xarelto？）与机械疗法（足底泵，抗栓塞放疗）联合预防的临床特征，以预防深静脉血栓形成（DVT）。材料和方法：本研究的受试者为2011年11月至2012年5月之间进行全膝关节置换术（TKA）的110例患者，并进行了前瞻性评估。他们由13名男性（11.8％）和97名女性（88.2％）组成，平均年龄为68.7岁（±7.9）。从术后第1天起，所有患者均在术后第14天每天接受一次10毫克利伐沙班治疗，术后立即使用间歇性气动加压（IPC）泵和加压袜。为了确定术后DVT的存在，进行临床症状检查，D-二聚体试验，彩色多普勒超声检查以分析DVT事件的危险因素。结果：在全部110例患者中，下肢远端DVT共13例（11.8％）。术后第4天，仅DVT组和非DVT组之间在几种临床症状的股骨肿胀上有统计学意义的差异（p = 0.043）。 D-二聚体试验显示两组之间无统计学差异，但边界值为0.3 mg / L时，诊断灵敏度，特异性，阳性可预测性和阴性可预测性分别为100％，8.2％，12.7％和分别为100％。两组之间在已知的危险因素（包括年龄，性别，肥胖，高血压，糖尿病，吸烟和麻醉方法）方面没有显着差异，并且未观察到肺栓塞的病例。结论：TKA后联合药物治疗（利伐沙班，Xarelto？）和机械治疗（足底泵系统）被认为对DVT预防有效。

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