Abstract:Objective To study the value of anti-Xa factor activity monitoring combined with ATⅢ activity detection in preventing bleeding and venous thrombosis after total knee arthroplasty(TKA) by aprospective study.Methods 74 patients with osteoarthritis who underwent unilateral TKA surgery in our hospitalwere selected and randomly divided into the experimental group and the control group.The experimental group was given subcutaneous injection of low molecular weight heparin (LMWH) 4 250 IU 12 hours after operation.The coagulation index and the activity of anti-Xa factor were detected 4 hours later,and the dose of LMWH was adapted according to the activity of anti-Xa factor.The activity of anti-Xa factor was maintained between 0.3~0.7 IU/mL.The control group was given subcutaneous injection of LMWH 4 250 IU 12 hours after operation.The coagulation index was detected 4 hours later,and the routine subcutaneous injection of LMWH 4 250 IU once/day anticoagulation therapy was given on the second day after operation.In the two groups,APTT,D-two dimers (D-Di),Hb,lower limb color Doppler ultrasound the subcutaneous hemorrhagewere routinely recorded and analyzed in 1 d,6 d and 11 d after operation.Results On the 1st day after operation,there was no statistically difference in APTT,D-Di,Hb,thrombus incidence and subcutaneous hemorrhage area (percentage of body surface area) between the two groups (P>0.05).On the 6th day after operation,there was no statistically difference in APTT between the two groups (P>0.05).But,D-Di,Hb change afteroperation,thrombosis incidence,and the area of subcutaneous hemorrhage of the experimental group was lower then control group (P<0.05).On the 11th day after operation,there was no statistically difference in APTT between the groups (P>0.05).D-Di,Hb and preoperative difference,thrombosis incidence,and the area of subcutaneoushemorrhage of the experimental group was lower then control group(P<0.05).Conclusion Using LMWH anticoagulant therapy after TKA,detecting the activity of AT Ⅲ before operationand adjusting the dosage of LMWH according to the activity of anti-Xa factorduring the anticoagulation can effectively reduce the incidence of postoperative lower extremity venous thrombosis and the risk of bleeding.Thistreatment should be promoted in clinical practice.
阿卜杜合力力·艾尼,巨啸晨,孙荣鑫 *. 抗Xa因子活性监测及ATⅢ活性检测在TKA术后血栓与出血预防中的应用价值[J]. 实用骨科杂志, 2021, 27(7): 610-614.
Abuduhelili Aini,Ju Xiaochen,Sun Rongxin *. Application Value of Anti-Xa Factor Activity Monitoring and ATⅢActivity Detection in Prevention of Thrombosis and Hemorrhage after TKA. sygkzz, 2021, 27(7): 610-614.
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