目的 探討利伐沙班預(yù)防骨科下肢大型手術(shù)后深靜脈血栓（DVT）的效果。方法 選取80例下肢進(jìn)行大型手術(shù)的患者，隨機(jī)分為兩組，對(duì)照組（39例）sc依諾肝素鈉注射液，觀察組（41例）口服利伐沙班。觀察并記錄兩組患者血液動(dòng)力學(xué)指標(biāo)、DVT診斷指標(biāo)、隨訪1個(gè)月期間并發(fā)癥發(fā)生情況，評(píng)價(jià)利伐沙班預(yù)防骨科下肢大型手術(shù)后DVT的效果。結(jié)果 術(shù)前，兩組血小板計(jì)數(shù)、血紅蛋白、血漿凝血酶原時(shí)間（PT）值相比，差異無(wú)統(tǒng)計(jì)學(xué)意義。與術(shù)前相比，術(shù)后3 d兩組血小板計(jì)數(shù)、血紅蛋白沒有明顯改變，PT值顯著增加（P<0.05）。兩組間血小板計(jì)數(shù)、血紅蛋白相比，差異無(wú)統(tǒng)計(jì)學(xué)意義，但觀察組PT值顯著高于對(duì)照組（P<0.05）；術(shù)后1 h，兩組D-二聚體（D-dimer）、同型半胱氨酸（Hcy）和超敏-C反應(yīng)蛋白（hs-CRP）值相比，差異無(wú)統(tǒng)計(jì)學(xué)意義。與術(shù)后1 h相比，術(shù)后3 d兩組D-dimer、Hcy、hs-CRP值均明顯下降且觀察組上述指標(biāo)均低于對(duì)照組（P<0.05）；術(shù)后隨訪1個(gè)月，雖然兩組各類并發(fā)癥發(fā)生率相比，差異無(wú)統(tǒng)計(jì)學(xué)意義，但對(duì)照組在DVT、繼發(fā)出血并發(fā)癥發(fā)生率上高于觀察組。結(jié)論 利伐沙班對(duì)DVT形成具有較好的預(yù)防效果，適用于骨科下肢大型手術(shù)后的抗凝治療，值得臨床推廣使用。

Objective To discuss the effect of rivaroxaban in preventing deep venous thrombosis after large orthopedic operation of lower extremity. Methods Totally 80 patients after lower extremity of large orthopedic operation were selected, they were divided into two groups randomly. The patients in control group (39 cases) were sc injected with enoxaparin through. The patients in observation group (41 cases) were given rivaroxaban orally. The effect of rivaroxaban in preventing deep venous thrombosis after large orthopedic operation of lower extremity were evaluated by hemodynamic indexes, diagnosis index, and complications during 1 months follow-up. Results Before operation, there was no statistical significance on platelet, hemoglobin, and PT values between two groups. Compared with the value before operation, the value of platelet and hemoglobin had no significantly change after 3 d of operation. But the PT was increased (P<0.05). After 3 d of operation, there was no statistical significance on platelet and hemoglobin between two groups. But the PT value of observation was higher than that of control group (P<0.05). After 1 h operation, there was no statistical significance on D-dimer, Hcy, and hs-CRP between two groups. Compared with the value after 1 h of operation, the values of D-dimer, Hcy, and hs-CRP were decreased significantly (P<0.05). And the indexes of observation group were lower than those of control group (P<0.05). After 1 months of operation, although there was no statistical significance on complications between two groups, the incidence rate of secondary bleeding and DVT of control group was higher than that of the observation group. Conclusion The rivaroxaban could prevent DVT well, which is suitable for the anticoagulation therapy after lower extremity of large orthopedic operation with little influence on platelet and hemoglobin. It is worthy of clinical application.