Effect comparison between rivaroxaban and low molecular weight heparin in the prevention of deep venous thrombosis after hip and knee joint arthroplasty

Objective:To compare the clinical efficacy between rivaroxaban and low molecular weight heparin calcium injection in the prevention of deep venous thrombosis after hip and knee joint arthroplasty,and guide clinical rational use of anticoagulant.Methods:One hundred patients with hip and knee arthroplasty were randomly divided into the rivaroxaban group and low molecular weight heparin group(50 cases each group).The rivaroxaban group was treated with 10 mg of rivaroxaban once daily by oral after 8 hours of operation,and the low molecular weight heparin group was treated with 5 000 AXaIU of low molecular weight heparin once daily by subcutaneous injection after 12 hours of operation.Two groups were continuously treated for 2 weeks.The blood coagulation indexesincluding platelet,activated partial thromboplastin,prothrombin time and incidence rate of lower extremity deep venous thrombosis(DVT) were compared between two groups.Clinical pharmacists participated in the treatment process,and provided pharmaceutical care.Results:The platelet counts and coagulation parameters in two groups were normal before surgery,and the difference of which was not statistically significant between two groups(P>0.05).The platelet counts and coagulation parameters in the two groups were normal before treatment and after 14 days of treatment,and the difference of which was not statistically significant between in two groups(P>0.05).The incidence rates of DVT in rivaroxaban group and low molecular weight heparin group were 0%(0/50) and 8%(4/50),respectively,and the difference of which was statistically significant between the two groups(P<0.05).The incidence rates of adverse reactions in rivaroxaban group and low molecular weight heparin group were 2%(1/50) and 12%(6/50),respectively,and the difference of which was not statistically significant between the two groups(P>0.05).Conclusions:Rivaroxaban can effectively prevent the occurrence of thrombosis in lower extremities deep vein after hip and knee joint arthroplasty,does not increase the risk of bleeding and has good safety,and the curative effect of which is equivalent to low molecular weight heparin.Rivaroxaban has the advantages of oral administration,fixed dose,satisfactory efficacy,and need not monitor.