The Clinical Study Of Rivaroxaban Treatment In Preventing Deep Venous Thrombosis After Total Hip Arthroplasty(THA)about Elderly Diabetes Patients

Objective:This research aimed to compare the clinical effect and safety about rivaroxaban and low-molecular-weight heparin(LMWH) to cure and prevent deep venous thrombosis(DVT) about elderly patients with diabetes mellitus after total hip arthroplasty(THA).Methods:Between May 2014 and August 2015, 72 elderly patients undergoing selective total hip arthroplasty in our hospital were enrolled in this issue. All patients were diagnosed with diabetes mellitus. They were completely randomly divided into two groups. Group A: 36 patients received rivaroxaban at a dose of 10 mg orally every 24 hours. Group B:36 patients received low-molecular-weight heparin(LMWH) subcutaneously once daily at a dose of 4100 IU. The therapeutic modalities were initiated in 10 hours after surgery.The ultrasonography of the deep veins of the both legs was executed on preoperative and postoperative. We observe and record the incidence of deep vein thrombosis and bleeding. Fasting glucose and coagulation indicators were tested before surgery, and the2 nd day, the 7th day and the 14 th day after surgery.Results:The total incidence rate of deep vein thrombosis(2.8%) in group A was inferior to group B(5.6%), but there was no statistical significance(P>0.05). Comparing in the value of the D-dimmer on the second day and the seventh day increased obviouslycompared with preoperative, we found the difference was statistically significant(P<0.05). The value of the D-dimmer has decreased in the 7th day and the14 th day after surgery compared with the 2nd day after operation and the difference was statistically significant(P<0.05). Compared with two groups, the difference about the value of D-dimmer of the 2nd day was no statistically significant(P>0.05). At the same time, we found the difference on the value of D-dimmer of the fourteenth day was statistically significant(P<0.05). There was no significant difference in bleeding, fasting glucose, PT and APTT compared with two groups(P>0.05).Conclusion:Rivaroxaban is superior to low molecular weight heparin(LMWH) for preventing to deep vein thrombosis on elderly diabetes mellitus patients after total hip arthroplasty.There is little impact on fasting glucose and no significant increase in bleeding.