Effect Of Warfarin Combined With Urokinase On Prevention Of Deep Vein Thrombosis Of Lower Extremities After Hip Arthroplasty

Objective:To investigate the efficacy of warfarin combined with urokinase in the prevention of deep venous thrombosis after hip replacement.Methods:Fifty-eight patients underwent hip arthroplasty in our hospital from October 2014 to October 2016.They were randomly divided into observation group and control group(n = 29).The initial dose was 3-4mg/d after 12 hours of artificial hip arthroplasty,and the initial dose was 3-4mg/d.The patients were treated with 2.5-5mg/d and adjusted for 14 days according to the patient’s condition.The observation group In the control group based on the addition of urokinase,300,000 IU dissolved in 300ml of saline,in the patient’s dorsal vein input,1/d,continuous treatment for 14d.The patients were followed up for 3 months.The incidence of deep venous thrombosis of the lower extremities was examined by color Doppler ultrasonography method.The changes of the lower limb circumference were measured at 14 days after operation and 14 days after anticoagulation.The changes of hemorheology and coagulation were measured by two groups of patients.At the same time,INR was measured.Results:(1)In the three months of follow-up,there was only 1 case of venous thrombosis in the observation group,the incidence was 3.45%;the control group had 6 cases of venous thrombosis,the incidence of 20.69%;observation group The incidence of venous thrombosis in lower extremities was significantly lower than that in control group(P<0.05).The difference was statistically significant.(2)There was no significant difference in the difference of thigh circumference and calf circumference between the observation group and the control group before anticoagulation(P>0.05).After 14 days of anticoagulation treatment,the thigh circumference of the two groups(P<0.05),and the observation group was significantly smaller than the control group,P<0.05,the difference was statistically significant.(Hb),plasma viscosity(ηp)and hematocrit(Hct)were not significantly different between the observation group and the control group before anticoagulation therapy(Hb),plasma viscosity(ηp)and erythrocyte dullness(Hct)were significantly higher in the two groups(P>0.05).After 14 days of anticoagulation,the plasma viscosity(ηbh)(P<0.05),and the observation group was significantly lower than the control group,P<0.05,the difference was statistically significant.(4)The levels of PT,APTT and D-dimer in the observation group were not significantly different from those in the control group(P>0.05).After 14 days of anticoagulation,PT,APTT and D-dimer(P>0.05),There was no significant difference in PT and APTT between the two groups(P>0.05).The levels of PT and APTT in the control group were significantly different from those in the control group(P>0.05),and there was significant difference between the two groups(P<0.05).The level of D-dimer was significantly different between the two groups(P<0.05).(5)There was no serious bleeding in the observation group and the control group.The incidence of non-severe bleeding was 27.59%in the observation group and 24.14%in the control group.The incidence of non-severe bleeding observed in the observation group and the control group has no significant difference(P>0.05).Conclusion:(1)The combination of warfarin and urokinase after hip arthroplasty can effectively reduce the incidence of deep venous thrombosis of lower extremities.(2)hip arthroplasty combined with urokinase can significantly reduce the lower limb circumference and improve hemorheology.(3)The combination of warfarin and urokinase in the prevention of deep venous thrombosis of the lower extremities after total hip arthroplasty was superior to that of warfarin alone.