中文摘要：

目的：探讨应用利伐沙班和低分子肝素预防髋膝关节置换术后深静脉血栓形成的疗效比较。方法：选择于2011年3月至2012年12月在我院行人工髋关节和膝关节置换手术的患者102例，随机分成利伐沙班组和低分子肝素组各51例。在髋膝关节置换术后，低分子肝素组给予低分子肝素钠4100IU／d皮下注射，持续用药2周；利伐沙班组给予利伐沙班片10mg／d口服，持续用药2周。于治疗第2周后采用彩色多普勒超声检查2组患者深静脉血栓的形成情况，并检测术前术后活化部分凝血活酶时间、凝血酶原时间及血小板各项指标和记录术后引流量。结果：低分子肝素组发生深静脉血栓7例（1．7％），利伐沙班组发生深静脉血栓3例（5．9％），2组深静脉血栓发生率比较差异有显著性（P〈0．05）。2组术后引流量、血液指标比较差异无显著性，利伐沙班组无明显不良反应发生。结论：利伐沙班能有效预防髋关节和膝关节置换术后深静脉血栓形成，具有良好的安全性，值得临床推广。

英文摘要：

Objective： To investigate the clinical efficacy of rivaroxaban verses low molecular weight heparin （LMWH） on preventing deep vein thrombosis （DVT） in postoperative hip or knee arthroplasty. Methods： From Mar 2011 to Dec 2012, 102 patients with hip or knee arthroplasty by operation in our hospital were selected and randomly divided into two groups, rivaroxaban and LMWH groups, 51 patinets in each group. The rivaroxaban group was given oral rivaroxaban 10 mg/d at postoperative 6 h, once a day for continuous 2 weeks. The LMWH group was given LMWH 4 100 IU/d with in postoperative 6 h, by subcutaneous injection for continuous 2 weeks. The DVT formation was detected by color Doppler ultra sound and compared between two groups after 2 week treatment. AFIT, PT and PLT were detected at preoperation and postoperation and drainage amount was recorded at postoperation. Results： Seven patients had DVT in the LMWH group with the occurrence rate of 13.7% and 3 patients had DVT in the rivaroxaban group with the occurrence rate of 5.9%. There was statistical difference between two groups （P 〈 0.05 ）. The rivaroxaban group had no obvious adverse reactions. Conclusion： Rivaroxaban can effectively prevent postoperative DVT in hip or knee arthroplasty and has good security with less adverse reactions, which can be used in clinical practice.