関連する実験動画
膝関節整形手術後の血栓予防のためのリバロキサバン対エノキサパリン (RECORD4):ランダム化試験
Alexander G G Turpie1, Michael R Lassen, Bruce L Davidson
1McMaster University, Hamilton, Ontario L8L 2X2, Canada. turpiea@mcmaster.ca
Lancet (London, England)
|May 5, 2009
まとめ
口服リバロキサバンは,全膝関節整形手術後の静脈性血栓栓塞栓の予防に,エノキサパリンと比較して優れた有効性を示しました. この研究は,膝の置換手術を受ける患者の効果的な口腔予防療法による短期間の入院をサポートしています.
科学分野:
- 整形外科 整形外科
- 薬理学 薬理学とは
- 血管医学 血管医学とは
背景:
- 静脈血栓塞栓症 (VTE) 予防は,膝関節整形手術 (TKA) 後の標準的なものです.
- 口服抗凝固剤は,短期間の入院を容易にする可能性があります.
- TKA VTE予防のための口服リバロキサバンの有効性と安全性が調査されました.
研究 の 目的:
- TKA後のVTE予防のためのエノキサパリンと比較して経口リバロキサバンの有効性を評価する.
- リバロキサバンに関連した安全性プロファイル,特に主要な出血イベントを評価する.
主な方法:
- ランダム化,ダブルブラインド,フェーズIII試験で,TKAを受けた患者3148人が参加しました.
- 患者は口服リバロキサバン (10 mg/日) または皮下エノキサパリン (30 mg/日2回) を投与された.
- 強制的な静脈検査は11日から15日の間に実施され,主効性は複合性VTEまたは死亡であり,主安全性は大きな出血でした.
主要な成果:
- リバロキサバンは,静脈動脈突発症の統計的に有意な減少を示した (6.9%対10.1%,p=0.0118).
- 重度の出血はリバロキサバン患者の0.7%とエノキサパリン患者の0.3%で発生した (p=0.1096).
- リバロキサバンは,エノキサパリンに劣らず,エノキサパリンに優れていると判明しました.
結論:
- 口服リバロキサバン (10〜14日間1日1回10mg) は,TKA後のVTE予防の優れた選択肢です.
- この発見は,患者の回復を促進し,入院期間が短縮される可能性があるために,経口抗凝固薬の使用を支持しています.
関連する概念動画
Venous Thrombosis III: Interprofessional Care
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Anticoagulant Drugs: Low-Molecular-Weight Heparins
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
Venous Thrombosis I: Introduction
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...