Brugger H P, Pirovino M
Medizinische Universitätsklinik, Inselspital Bern.
Schweiz Med Wochenschr. 1989 Jan 7;119(1):16-8.
Four cases of severe bleeding among 50 elderly patients undergoing subcutaneous calcium heparin treatment are reported. In three patients the bleeding was localized in the abdominal wall and the fourth in the retroperitoneum; 2 patients died. Heparin doses ranged between 2x12,500 and 2x20,000 I.U/day. The thrombin times, measured before the next administration, were in the subtherapeutic range in all patients. We conclude that in elderly patients subcutaneous heparin treatment in therapeutic doses should be reserved for exceptional cases.
报告了50例接受皮下注射肝素钙治疗的老年患者中有4例发生严重出血。3例患者的出血部位在腹壁,第4例在腹膜后;2例患者死亡。肝素剂量为每日2×12,500至2×20,000国际单位。在下一次给药前测得的凝血酶时间在所有患者中均处于亚治疗范围。我们得出结论,对于老年患者,治疗剂量的皮下肝素治疗应仅用于特殊情况。