Abstract：
The purpose of the study is to determine the efficacy and safety of postoperative single-dose anticoagulant treatment in preventing venous thromboembolism (VTE) after revision THA, in comparison with a multiple-dose chemoprophylaxis protocol.
We retrospectively compared 295 patients undergoing revision THA who received multiple-dose chemoprophylaxis protocol (40 mg low-molecular-weight heparin once and oral rivaroxaban for 10 days) or single-dose chemoprophylaxis protocol (40 mg low-molecular-weight heparin once) for VTE. The patients in both groups performed active lower limb exercises. Each group was further stratified into subgroups based on the aetiology of revision. The incidence of VTE, wound complications within three months, hidden blood loss (HBL), transfusion rate, and surgical drainage duration were recorded.
The incidence rates of VTE (P = 0.870) did not differ between the two prophylaxis protocols. However, significant differences were observed in wound complications within three months (P = 0.002), HBL (P = 0.015), transfusion rate (P = 0.028). Surgical drainage duration was also shorter in the single-dose chemoprophylaxis group (P = 0.0023). In the subgroup analysis, the use of single-dose chemoprophylaxis protocol cannot significantly reduce HBL and transfusion rate after septic revision THA. The use of multiple-dose chemoprophylaxis protocol (OR = 2.89, P = 0.002) and high BMI (OR = 1.09, P = 0.037) were independent risk factors of wound complications.
Single-dose chemoprophylaxis protocol effectively and safely prevented VTE after revision THA compared with multiple-dose chemoprophylaxis protocol. The effect in reducing HBL and postoperative transfusion rate was limited in septic revision.
We retrospectively compared 295 patients undergoing revision THA who received multiple-dose chemoprophylaxis protocol (40 mg low-molecular-weight heparin once and oral rivaroxaban for 10 days) or single-dose chemoprophylaxis protocol (40 mg low-molecular-weight heparin once) for VTE. The patients in both groups performed active lower limb exercises. Each group was further stratified into subgroups based on the aetiology of revision. The incidence of VTE, wound complications within three months, hidden blood loss (HBL), transfusion rate, and surgical drainage duration were recorded.
The incidence rates of VTE (P = 0.870) did not differ between the two prophylaxis protocols. However, significant differences were observed in wound complications within three months (P = 0.002), HBL (P = 0.015), transfusion rate (P = 0.028). Surgical drainage duration was also shorter in the single-dose chemoprophylaxis group (P = 0.0023). In the subgroup analysis, the use of single-dose chemoprophylaxis protocol cannot significantly reduce HBL and transfusion rate after septic revision THA. The use of multiple-dose chemoprophylaxis protocol (OR = 2.89, P = 0.002) and high BMI (OR = 1.09, P = 0.037) were independent risk factors of wound complications.
Single-dose chemoprophylaxis protocol effectively and safely prevented VTE after revision THA compared with multiple-dose chemoprophylaxis protocol. The effect in reducing HBL and postoperative transfusion rate was limited in septic revision.
摘要：
目的：本研究的目的是确定术后单剂量抗凝治疗在预防THA修订后静脉血栓栓塞（VTE）中的疗效和安全性，与多剂量化学预防方案相比。
方法：我们回顾性比较了295例接受修正THA的患者，这些患者接受多剂量化学预防方案（一次40mg低分子量肝素和10天口服利伐沙班）或单剂量化学预防方案（一次40mg低分子量肝素）治疗VTE。两组患者均进行积极的下肢锻炼。根据翻修的病因，将每组进一步分为亚组。VTE的发病率,三个月内伤口并发症，隐性失血（HBL），输血率，记录手术引流时间。
结果：两种预防方案之间的VTE发生率（P=0.870）没有差异。然而,3个月内伤口并发症差异显著(P=0.002),HBL(P=0.015),输血率(P=0.028)。单剂量化学预防组的手术引流时间也较短（P=0.0023）。在亚组分析中，使用单剂量化学预防方案不能显著降低脓毒症修正THA后的HBL和输血率.采用多剂量化疗方案(OR=2.89,P=0.002)和高BMI(OR=1.09,P=0.037)是切口并发症的独立危险因素。
结论：与多剂量化学预防方案相比，单剂量化学预防方案可有效且安全地预防修订THA后的VTE。在脓毒症翻修中，降低HBL和术后输血率的作用有限。
方法：我们回顾性比较了295例接受修正THA的患者，这些患者接受多剂量化学预防方案（一次40mg低分子量肝素和10天口服利伐沙班）或单剂量化学预防方案（一次40mg低分子量肝素）治疗VTE。两组患者均进行积极的下肢锻炼。根据翻修的病因，将每组进一步分为亚组。VTE的发病率,三个月内伤口并发症，隐性失血（HBL），输血率，记录手术引流时间。
结果：两种预防方案之间的VTE发生率（P=0.870）没有差异。然而,3个月内伤口并发症差异显著(P=0.002),HBL(P=0.015),输血率(P=0.028)。单剂量化学预防组的手术引流时间也较短（P=0.0023）。在亚组分析中，使用单剂量化学预防方案不能显著降低脓毒症修正THA后的HBL和输血率.采用多剂量化疗方案(OR=2.89,P=0.002)和高BMI(OR=1.09,P=0.037)是切口并发症的独立危险因素。
结论：与多剂量化学预防方案相比，单剂量化学预防方案可有效且安全地预防修订THA后的VTE。在脓毒症翻修中，降低HBL和术后输血率的作用有限。
