| Objective:The main purpose of this study is to contrast the effectiveness of the new oral anticoagulant--Apixaban and Rivaroxaban after total knee arthroplasty (TKA).Methods:The study included 60 patients who were under unilateral TKA from Oct.2013 to Sept.2014 in the joint center of the First Affiliated Hospital of Chongqing Medical University. Among them,30 were for Apixaban, and the patients were given 2.5mg(oral, bid) of Apixaban for 14 days after surgery; the other 30 were for Rivaroxaban, and the patients were given 10mg(oral,qd) of Rivaroxaban for 14 days after surgery. Then the deep venous thrombosis, blood loss, ecchymosis, change of D-dimer postoperative, change of the perimeter of the operated leg and the ROM of the joint prosthesis were observed.Results:No venous thrombosis and pulmonary thromboembolism in both groups was found during the period of drug tkaking after surgery.There was no statistically significant difference in dominant blood loss between Apixaban group and Rivaroxaban group (p>0.05);the hidden blood loss in Apixaban group was lower than that in Rivaroxaban group at the 3 rd,7th,14th day after operation(p<0.05). The incidence of ecchymosis was 26.67%(8/30) in Apixaban group and 63.33%(19/30) in Rivaroxaban group (p<0.05);there was no statistically significant difference in operation time, change of D-dimer, change of perimeter of the operated leg or the ROM of the joint prosthesis after operation(p>0.05). There was one case of asymptomatic muscle thrombus in Rivaroxaban group which was given no special treatment.All wounds recovered well.Conclusion:Apixaban and Rivaroxaban taken orally were both effective for preventing venous thrombosis after total knee arthroplasty operation, but the effect of Apixaban on hidden blood loss is smaller than that of Rivaroxaban and is a lower incidence of ecchymosis. Therefore, the effectiveness of Apixaban is better than that of Rivaroxaban. |
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