Abstract: Objective To observe the effect of the rivaroxaban and low molecular weight heparin calcium to prevent deep vein thrombosis (DVT) after artificial joint replacement. Methods 167 patients included 114 cases for total hip arthroplasty and 53 cases for total knee replacement from Novermber, 2009 to October, 2010 were divided into two groups: observation group (n=84) was treated with rivaroxaban tablets, 6 h after surgery, 10 mg/d, 2 weeks for knee arthroplasty, 5 weeks for total hip arthroplasty; and control group (n=83) was treated with low molecular weight heparin calcium 2500 IU 2 h before and after surgery for 5 d. Ultrasonography was used to detect the deep vein lumen size change and DVT rate of bilateral lower extremities in all patients before and after surgery. Activated partial thromboplastin time (APTT) was tested before surgery, and 2 d, 5 d, 7 d, 14 d, 35 d after surgery. Results ① Incidence of DVT showed that there were 9 cases (10.7%) with DVT in the observation group; there were 15 cases with DVT (18.1%) in the control group. ② Lower limb deep vein lumen size change comparison: there were 23 cases (27.4%) with superficial femoral vein stenosis more than 2 mm in the observation group while 38 cases (45.8%) in the control group, there were 27 cases (32.1%) with popliteal veins stenosis more than 2 mm in the observation group and 47 cases (56.6%) in the control group (P<0.01). ③APTT: APTT prolonged >10 s was 0 in the observation group while 23 cases (27.7%) in the control group (P<0.01). Conclusion Trivaroxaban may prevent DVT after artificial joint replacement and be better than low molecular weight heparins calcium.

Key words: rivaroxaban, low molecular weight heparin calcium, joint replacement, deep vein thrombosis