| Objective:In this study,the hidden hemorrhage of perioperative period was compared with the use of aspirin and rivaroxaban as anticoagulant drugs after primary unilateral total knee arthroplasty.To explore the effect of two drugs on perioperative hidden hemorrhage,and to provide the basis and reference for clinicians to select anticoagulant drug after TKA in practical clinical work.Methods:Selected 80 cases admitted to Department of Orthopaedic Medical Center from November 2016 to September 2017 in the second hospital of Jilin University,who was diagnosed with knee osteoarthritis,data integrity,and underwent primary unilateral total knee arthroplasty,All patients were divided into two groups using a random number table method,aspirin group and rivaroxaban group,no significant difference between the two groups of patients with general information comparison(P>0.05)(see article).The two groups of patients were given the same perioperative management,anesthesia and operation,and the operation was performed by the same group of clinicians.From the first day after operation,patients in the aspirin group application of aspirin enteric-coated tablets(Bayaspirin)100mg/day and patients in the rivaroxaban group were treated with rivaroxaban tablets(Xarelto)10mg/day as anticoagulant drugs for 14 days.All patients were recorded the amount of overt hemorrhage,operation time,the application time of the electric tourniquet,the amount of blood transfusion and the flow rate after operation.All patients were routinely collected blood routine for preoperative and postoperative 1,3,5 days and recorded Hematocrit(Hct).On the fifth day after operation,the color doppler ultrasound of the lower extremities was performed,and the formation of Deep Vein Thrombosis(DVT)was recorded.The patients ' postoperative hospitalization time,the condition of incision healing and subcutaneous congestion,the 5th day knee joint activity were recorded.Then the Gross formula was used to calculate the postoperative hidden hemorrhage.The relative parameters of the two groups were compared and the effects of the two oral anticoagulants on the hidden hemorrhage during TKA perioperative period were discussed.Results:1.There was no statistically significant difference in the general data of two groups(p>0.05),which was comparable.2.The actual total blood loss of the aspirin group in the perioperative period of TKA was 1411±411ml,which was less than the rivaroxaban group which was 1557±407ml,there was no statistically significant difference(p>0.05),The dominant blood loss of the aspirin group was 755±203ml and that of 725±185ml in the rivaroxaban group,there was no statistically significant difference(p>0.05).The hidden hemorhage of the aspirin group was 655±219ml and that of 832±248ml in the rivaroxaban group,there were statistical differences between them(P<0.05).The proportion of recessive blood loss in the aspirin group was 40.96±3.19%,and that of 53.12±4.47% in the rivaroxaban group,there were statistical differences between them(P<0.05).3.There was no statistically significant difference in the postoperative average hospitalization day,the knee joint activity and incidence of thrombosis and incision complicationin of 5th day after operation between two groups(p>0.05),Conclusion:1.The hidden hemorrhage in the perioperative period of the initial unilateral TKA can reach 50% of the total actual blood loss,and should be paid enough attention..2.Compared with rivaroxaban,aspirin reduced the hidden hemorhage after primary unilateral TKA,the proportion of hidden hemorhage to the actual total blood loss and the incidence of subcutaneous congestion.3.Two kinds of oral anticoagulant drugs had no significant difference in the average hospitalization days,early knee function recovery and thrombosis complications after primary unilateral TKA operation.They were worthy of application.Clinical application should grasp their indications and monitor the patient's condition and blood routine. |
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