Effect Of Rivaroxaban On Prevention Of Deep Vein Thrombosis After Total Joint Replacement

[Objectives] To evaluate the effect of Rivaroxaban on prevention of deep venous thrombosis(DVT) after total joint replacement (TJR) by comparing the clinical efficacy and security of Rivaroxaban(10mg, per day, orally taken) with that of low molecular weight heparin (LMWH)(0.4ml, per day, hypodermic injection).[Methods] Retrospectively analyse60TJR patients, divided into two groups: Rivaroxaban group with30cases and LMWH group with30cases. Patients in former group took Rivaroxaban every day until1month after discharge. Patients in latter group took LMWH every day in hospital and took Rivaroxaban instead for1month after discharge. Both of two groups took initial medications12hours right after the surgery. There were no statistical significance in terms of differences of general conditions like gender, age, height, weight, duration of disease and so on (P>0.05). It was kept consistent on preparation and prescription after surgery. All surgeries were done by the same doctors. To note oxyhemoglobin saturation and the new symptoms after surgery, especially shortness of breath and chest tightness. To count the total volume of blood loss with the values of blood routine examinations taken pre-surgery and2rd day post-surgery. To count dominant blood loss by recording amount of blood loss in surgery, drainage and exudation afer extubation. To note the possible formation of partial hematoma or haemorrhage of skin and mucosa. To compare changes of hemoglobin, PLT, PT, APTT and D-Di at the time of pre-surgery,2rd and10th days post-surgery. To recheck the color dopplar ultrasound of lower limbs to evaluate DVT. To note haemorrhagic events within30days after surgery. To assess the clinical efficacy and security by comparisons of these values mentioned above.[Results]3cases developed DVT in total with the incidence of5percent. Rivaroxaban group had1case of asymptomatic DVT with the incidence of3percent while LMWH group had1case of DVT with symptoms of shortness of breath and chest tightness, and1case of asymptomatic DVT. No statistical significance on incidence of DVT bewteen two groups (x2=0.351, P=0.554). The total blood loss and dominant blood loss of Rivaroxaban group were (1125±246.12)mL and(435±67.5)mL, higher than those of LMWH group (1087±229.5) mL and (392±113.7) mL, but of no statistical significance (P>0.05).The differences of changes of HGB, PLT, PT, APTT and D-Di bewteen two groups were also of no statistical significance(P>0.05). Neither of two groups developed partial hematoma or haemorrhage of skin and mucosa, or any haemorrhagic events like haematemesis, hematochezia and so on within30days after surgery.[Conclusion] Rivaroxaban has a good effect and security on prevention of DVT after TJR.