The Effect of Ulinastatin Continuous Infusion Combined Rivaroxaban on Coagulation Function in Patients Undergoing Major Orthopedic Surgery

YU Xi; L Guoyi; TIAN Yi; TIAN Guogang

doi:10.3969/j.issn.0253-9896.2013.07.020

Abstract：Objective To explore the effect of ulinastatin (UTI) continuous infusion combined rivaroxaban on coagu-lation function in patients undergoing major orthopedic surgery. Methods Forty-five patients undergoing major orthopedic surgery were randomly divided into three groups:ulinastatin continuous infusion (Uc) group, ulinastatin single injection (Us) group and control (C) group. All patients received patient-controlled intravenous analgesia (PCIA) after operation, and took rivaroxaban orally 12 hours after operation. Ulinastatin (5 000 U/kg) was given intravenously to both Uc and Us groups preop-eratively. Group C was given isometric normal saline, group Uc was pumped UTI continuous intravenously at the end of sur-gery (10 000 U/kg) to 48 hours through PCIA pump. The values of hematocrit (HCT), thrombin time (TT), fibrinogen (FIB), plasma prothrombin time (PT) and activated partial thromboplastin time (APTT) were normally tested before surgery (T1), at the end of the surgery (T2), 12 hours (T3), 24 hours (T4) and 48 hours (T5) after surgery. Results Compared with T1, there was a downward tendency in TT after operation in group C and group Us (P<0.05). The values of FIB, PT and APTT were signifi-cantly increased from 24-hour after surgery (P<0.05). In group Uc, there were no significant changes in TT after operation (P>0.05). Values of PT and APTT increased 12 hours earlier than those of group C (P<0.05). There was no substantial dif-ference in the level of FIB between three groups in the postoperative period (P>0.05). Conclusion During the periopera-tive period, ulinastatin continuous infusion combined rivaroxaban can improve the hypercoagulable state in patients undergo-ing major orthopedic surgery, and safe to use.