低分子肝素预防髋膝关节术后下肢深静脉血栓形成

PROPHYLAXIS FOR DEEP VEIN THROMBOSIS WITH LOW MOLECULAR WEIGHT HEPARIN FOLLOWING HIP AND KNEE SURGERY

目的 评价低分子肝素预防髋、膝关节术后深静脉血栓形成 (DVT)的疗效和安全性。方法1997年 4月～ 1998年 10月选择接受髋、膝周围手术的患者 46例均为 40岁以上 ,3个月内无血栓栓塞性疾病史、无凝血功能障碍 ,术前经彩色多普勒超声法筛查 ,双下肢无 DVT,随机分成两组。预防组应用低分子肝素 (速避凝 )预防 DVT,对照组不采用任何预防措施。术后第 4～ 7天行患侧静脉造影 ,了解深静脉血栓的发生情况。结果 对照组中 8例发生 DVT,占 34.8% ;预防组中 1例发生 DVT,占 4.3%。经统计学处理有显著性差异 (P<0 .0 5 )。两组均未发生明显的出血并发症。结论 低分子肝素能安全、有效地预防髋膝关节术后深静脉血栓形成。

Objective To evaluate the efficacy and safety of low molecular weight heparin( LMWH) in prophylaxis of postoperative deep vein thrombosis (DVT) following hip and knee surgery. Methods From April 1997 to October 1998, 46 patients undergoing hip and knee orthopedic procedures were randomized into 2 groups for studying. The following eligibility criteria were applied: age over 40 years old, no recently history of venous thromboembolism (over 3 months), normal result of preoperative hemostasis test and normal result of Doppler examination of the lower extremities. One group was control group and the other group received subcutaneously a low molecular weight heparin( Fraxiparine) with anti factor X a activity of 41 IU/kg·day for three days, then 62 IU/kg·day from the 4th day to 10th day. All patients had venegraphy performed in the operated leg at 4 to 7 days after surgery. Results eight patients(34.8%) developed DVT in the control group of 23 patients and 1 patient (4.3%) in the experimental group , also of 23 patients( P <0.05). Two groups had no any bleeding complications. Conclusion The low molecular weight heparin is safe and effective in preventing postoperative deep vein thrombosis in patients following hip and knee surgery.