Analysis Of Drugs Of Rivaroxaban Induced Coagulation Dysfunction After Hip Arthroplasty

Objective: 1.To analyze the causes of coagulation dysfunction after hip arthroplasty in order to give suggestions on the adjustment of medication plan.2.To evaluate the efficacy and safety of rivaroxaban and aspirin in hip and knee arthroplasty.Methods: 1.Clinical pharmacists searched all databases for research literature and case reports related to rivaroxaban.Combined with the patient’s past medical history,medication history,auxiliary examination and other basic information.The association,high risk factors and causes of coagulation dysfunction with rivaroxaban were analyzed in detail,and suggestions for adjusting medication were given.2.The databases of CNKI,VIP,Wanfang,Cochrane Library and Pub Med were searched to screen the randomized controlled trials(RCTs)of rivaroxaban versus aspirin in hip and knee arthroplasty.The bias risk assessment form provided by Cochrane Collaboration Network was used to evaluate the quality of included studies and extract data;Revman5.3 software was used for meta analysis.Results: 1.The patient took rivaroxaban tablets 10 mg every day for more than 10 days after hip replacement,and the coagulation function of the patient was abnormal on the day of admission.Clinical pharmacists considered that the abnormal coagulation function of patients was related to rivaroxaban,and suggested stopping rivaroxaban tablets and adjusting to aspirin for the prevention of venous thrombosis.The coagulation function of patients recovered and tended to be normal.2.7 RCTs involving4 111 subjects were included.Meta analysis: the incidence of VTE in rivaroxaban group was significantly lower than that in aspirin group [RR=0.58,95%CI(0.40,0.83),P=0.003].After treatment,there was no significant difference in hemoglobin reduction between rivaroxaban group and aspirin group [MD=-0.22,95%CI(-1.04,0.59),P=0.59].There was no significant difference in drain output between rivaroxaban group and aspirin group [MD=-8.75,95%CI(-36.52,19.03),P=0.54].There was no significant difference in blood loss between the two groups [MD=102.19,95%CI(-157.26,361.64),P=0.44].There was no significant difference in the incidence of bleeding between the two groups[RR=1.06,95%CI(0.62,1.79),P=0.84].Conclusion: Rivaroxaban is superior to aspirin in the prevention of thrombosis after hip and knee arthroplasty,and the safety of both is similar.However,in clinical practice,we can evaluate the risk benefit and give individualized treatment plan according to the specific condition of patients.