目的 比較利伐沙班與低分子肝素鈉在預(yù)防下肢深靜脈血栓方面的效果。方法 選取安康市中心醫(yī)院住院部下肢骨折患者120例，隨機(jī)分為兩組，每組60例，對(duì)照組術(shù)后24 h給予低分子肝素鈉預(yù)防，觀察組術(shù)后24 h給予利伐沙班預(yù)防。分別于術(shù)后24 h、5 d、10 d檢查患者血漿凝血酶-抗凝血酶ⅡI復(fù)合物（TAT）值以及檢測(cè)術(shù)后10 d和術(shù)前患者體內(nèi)血小板和血紅蛋白值，再結(jié)合10 d內(nèi)發(fā)生的出血和下肢深靜脈血栓（DVT）事件，評(píng)估利伐沙班和低分子肝素鈉在預(yù)防DVT的效果。結(jié)果 兩組下肢骨折患者術(shù)后24 h、5 d的TAT值明顯高于術(shù)前（P<0.05），與術(shù)后24 h時(shí)高水平TAT值相比，利伐沙班在術(shù)后5 d可以顯著降低血漿TAT值（P<0.05），并且降低水平顯著低于低分子肝素鈉（P<0.05）。兩組患者術(shù)后10 d體內(nèi)血小板和血紅蛋白值與術(shù)前比較，差異無(wú)統(tǒng)計(jì)學(xué)意義。觀察組在給藥后至術(shù)后10 d的時(shí)間里發(fā)生出血事件和DVT的概率均明顯小于對(duì)照組（P<0.05）。結(jié)論 與低分子肝素鈉相比，采用利伐沙班可較有效影響人體凝血系統(tǒng)，降低下肢深靜脈血栓發(fā)生率，減小出血事件。

Objective To compare the efficacies bewteen low molecular weight heparin (LMWH) and rivaroxaban in preventing deep vein thrombosis (DVT). Methods Totally 120 patients with fracture of lower limb being in hospital selected and they were devided into two groups, 60 in each group. After 24 h of surgery, the patients in control group were given LMWH and those in observation group were given rivaroxaban. TAT value was tested respectively on 24 h, 5 d, and 10 d after surgery. Blood platelet and hemoglobin were tested respectively on preoperation and 10 d after surgery. Combined with DVT and bleeding events happened in 10 d, the efficacy of preveting DVT was evaluated bewteen LMWH and rivaroxaban. Results The TAT values tested 5 and 10 d after surgery were significantly higher than those of pre-operation (P<0.05). Comparing with the high level TAT value on 24 h after surgery, rivaroxaban could descend TAT value significantly on 5 d after surgery (P<0.05) and the descending degree was significantly lower than that of LMWH (P<0.05). Compared with the blood platelet and hemoglobin between 10 d after surgery and pre-operation, there was no statistical significance. When using rivaroxaban, the probability of preventing DVT and reducing bleeding events was remarkably lower than that of LMWH (P<0.05). Conclusion Compared with LMWH, using rivaroxaban could affect the coagulation system effectively, decrease the probability of DVT, and reduce bleeding events.