Study Of The Correlation Between The Use Of Rivaroxaban To Prevent Deep Vein Thrombosis And D-dimer Value In Patients After Orthopedic Surgery

Objective:Deep vein thrombosis(DVT)refers to abnormal coagulation of blood in the deep vein,which belongs to the venous reflux disorder.It is often caused by improper bone tissue care in the surgical department after orthopedic surgery.It is particularly important for early prevention and control DVT in Joint surgery patients.This study mainly discusses the effect of rivaroxaban on prevention of deep vein thrombosis(DVT)in total knee arthroplastyre placement surgery,artificial femoral head replacement and total hip replacement patients.At the same time,the effect of pharmaceutical care for orthopaedic surgery patient is also discussed.Methods:Using retrospective analysis method,613 patients from January 2015 to February 2019 in department of joint surgery and undergoing total knee arthroplasty,artificial femoral head replacement and total hip replacement surgery were selected,among which 215 were male,398 were female,average age was 68.07±12.09.All subjects were excluded the elderly(more than 90 years old),pregnancy women,special patients with adverse reactions.Among them,72 cases unused rivaroxaban and honghua injection group(untreated group),267 cases using rivaroxaban and 274 patients combined use rivaroxaban and honghua injection group(combination group).Statistics of prothrombin time(PT),international standardization ratio(PTINR),partial prothrombin time(APTT),and D-dimer index,analysis of different postoperative medications with the relationship between four indexes and setting up pharmaceutical care point for patients with joint surgery to prevent deep vein thrombosis.Results:Prothrombin time(PT),international standardized ratio(PTINR),partial prothrombin time(APTT)and D-dimer values in the untreated group showed no statistical difference among the four groups.According to the gender statistical analysis results,there was no statistical difference among the four indexes among the treatment groups.Taking 65 years old as the age critical value,statistical analysis showed that the four indexes increased with the increase of age,and there were significant differences between the groups with age ≥65 years old and age<65 years old(P<0.05),and the D-dimer values in the rivaroxaban group also had significant differences.Prothrombin time,international standardized ratio and D-dimer value of female patients increased with age,and there were significant differences between the combined groups(P<0.05),and D-dimer value in the rivaroxaban group also had significant differences(P<0.05).Prothrombin time,international standardized ratio and D-dimer value of male patients all increased with age,and there were significant differences between rivaroxaban groups(P<0.05).Conclusion:Prothrombin time,international standardized ratio and partial prothrombin time are of reference value in evaluating and judging whether patients’coagulation function is normal.Age and sex were correlated with D-dimer values.D-dimer values increased with age and were higher in women than men in patients older than 65.It is suggested that the critical age,sex and D-dimer value of 65 years should be used to determine the postoperative drug regimen.Rivaroxaban can effectively prevent the formation of deep vein thrombosis in patients undergoing joint surgery.Rational use of rivaroxaban can effectively prevent deep vein thrombosis in patients after orthopaedic surgery and improve the therapeutic effect.The establishment of pharmaceutical care pathway and the monitoring of patients can not only promote rational drug use but also improve the therapeutic effect.