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总关节整形术后低分子量肝素剂量方案:一个前性,单中心,随机,双盲研究
Jingjing Shang1, Liangliang Wang2, Jinhong Gong1
1Department of Pharmacy, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China.
Journal of orthopaedic surgery and research
|November 27, 2024
概括
低分子量肝素 (LMWH) 是在关节置换后预防静脉血栓栓塞的标准. 一项研究发现,因子沙巴林治疗方案之间的血栓栓塞率没有显著差异,但手术后12小时的40毫克剂量减少了伤.
科学领域:
- 整形外科手术 整形外科手术
- 药理学 药理学是指药理学的学科.
- 血管医学 血管医学
背景情况:
- 低分子量肝素 (LMWH) 是预防静脉血栓塞栓症 (VTE) 在全关节整形术 (TJA) 后的标准.
- 证据支持特定的LMWH剂量方案用于TJA后的VTE预防是有限的.
- 这项研究解决了对优化LMWH剂量策略的需求.
研究的目的:
- 评估三种不同的埃诺沙巴林剂量方案在TJA后预防VTE的疗效和安全性.
- 为了比较不同类型的血栓事件,主要出血和二次结果,在不同类型的埃诺沙巴林注射方案中进行.
- 为了确定一个最佳的埃诺沙巴林剂量方案,用于TJA后的VTE预防.
主要方法:
- 一项随机对照试验,涉及536名接受关节或膝关节置换手术的患者.
- 三个素剂量组:手术后6小时20毫克 (A组),手术后6小时40毫克 (B组) 和手术后12小时40毫克 (C组).
- 主要结局:VTE和大出血在3个月内. 二次结局:,伤口排水和输血要求.
主要成果:
- 在所有三种埃诺沙巴林剂量方案中,血栓栓塞事件的发生率相对较低.
- 与A组和B组相比,C组 (40毫克12小时术后) 的术后湿疹发病率明显较低.
- 组B (40毫克6小时术后) 显示出更高的24小时和整体术后排水量.
结论:
- 在测试的埃诺沙巴林剂量方案中,没有观察到静脉血栓栓塞率的显著差异.
- 在术后12小时内服用40毫克的埃诺沙巴林剂量,可以证明减少了缩和排水,而不会增加血栓形成的风险.
- 这种方案表明,在全关节关节整形术后,对VTE预防有潜在的更安全,更有效的方法.
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