Lassen M R, Borris L C, Christiansen H M, Schøtt P, Olsen A D, Sørensen J V, Rahr H, Jensen H P
Department of Orthopedics, Aalborg Hospital, Denmark.
Semin Thromb Hemost. 1991;17 Suppl 3:284-90.
Several clinical studies have evaluated the efficacy and safety of LMWH in the prevention of postoperative thromboembolic complications. We subjected 42 studies to a statistical meta-analysis in order to evaluate the efficacy of different prophylactic regimens compared with LMWH prophylaxis. In general surgery LMWH was more effective than LDH three times daily and placebo, but comparable with LDH twice daily. In elective hip surgery, thromboprophylaxis with LMWH was more effective than placebo, LDH, and dextran 70, but comparable with LDH in combination with dihydroergotamine. In patients undergoing surgery for hip fractures LMWH was more effective than placebo, but the studies comparing LMWH with LDH were too small to show any clinically relevant difference, although there was a trend toward a better efficacy of LMWH. This study demonstrated that LMWH is clinically effective and safe to use in the prevention of thromboembolic complications after general and orthopedic surgery.
多项临床研究评估了低分子肝素（LMWH）预防术后血栓栓塞并发症的疗效和安全性。我们对42项研究进行了统计荟萃分析，以评估不同预防方案与LMWH预防相比的疗效。在普通外科手术中，LMWH比每日三次的低剂量肝素（LDH）和安慰剂更有效，但与每日两次的LDH相当。在择期髋关节手术中，LMWH预防血栓形成比安慰剂、LDH和右旋糖酐70更有效，但与LDH联合双氢麦角胺相当。在接受髋部骨折手术的患者中，LMWH比安慰剂更有效，但比较LMWH与LDH的研究规模太小，无法显示任何临床相关差异，尽管有LMWH疗效更佳的趋势。这项研究表明，LMWH在预防普通外科和骨科手术后的血栓栓塞并发症方面临床有效且安全。
