Hess P, Oertli D, Dürig M, Laffer U, Fridrich R, Jäger K, Harder F
Departement Chirurgie, Universität, Kantonsspital Basel.
Helv Chir Acta. 1992 May;58(6):931-5.
A prospective, randomized trial has been undertaken to evaluate the prophylactic effects of low molecular weight heparin (LMWH) and dextran-70 in 216 patients with hip fracture during a postoperative period of ten days. Deep vein thrombosis (DVT) was diagnosed using the 125Iodine fibrinogen uptake test, confirmed by ascending venography. 113 patients received LMWH and 103 dextran-70. The frequency of DTV of 14.2% in the LMWH group was significantly lower compared with the 30.1% in the dextran group (p less than 0.003). During the first 10 days postoperative there were no fatal pulmonary embolism (PE). After this period PE occurred in 2 patients (1.8%) in the LMWH group and 1 patient (1.0%) in the dextran group. In each group one patient died from PE. There was no major bleeding in either group. The frequency of local complications was slightly higher in the dextran group (10.7%) compared with the LMWH group (3.5%). The postoperative hemoglobin level was significantly lower in dextran treated patients than in patients receiving LMWH (p less than 0.0001).
一项前瞻性随机试验旨在评估低分子量肝素（LMWH）和右旋糖酐70对216例髋部骨折患者术后10天的预防效果。采用125碘纤维蛋白原摄取试验诊断深静脉血栓形成（DVT），并通过上行静脉造影加以证实。113例患者接受LMWH治疗，103例接受右旋糖酐70治疗。LMWH组DVT发生率为14.2%，显著低于右旋糖酐组的30.1%（p<0.003）。术后前10天无致命性肺栓塞（PE）发生。在此之后，LMWH组有2例患者（1.8%）发生PE，右旋糖酐组有1例患者（1.0%）发生PE。每组各有1例患者死于PE。两组均未发生大出血。右旋糖酐组局部并发症发生率（10.7%）略高于LMWH组（3.5%）。接受右旋糖酐治疗的患者术后血红蛋白水平显著低于接受LMWH治疗的患者（p<0.0001）。
