Dechavanne M, Ville D, Berruyer M, Trepo F, Dalery F, Clermont N, Lerat J L, Moyen B, Fischer L P, Kher A
Laboratoires d'Hémostase et de Médecine nucléaire, Hôpital E. Herriot, Lyon, France.
Haemostasis. 1989;19(1):5-12. doi: 10.1159/000215882.
124 patients undergoing total hip replacement were randomly allocated to receive Kabi 2165, 2,500 anti-Xa units twice a day (group A); Kabi 2165, 2,500 anti-Xa units twice a day during the first 48 h postoperatively and then 5,000 anti-Xa units once a day (group B), or adjusted-dose standard heparin, monitored by activated partial thromboplastin time (group C). The first dose was given 2 h before surgery in the three groups. Deep-vein thrombosis (DVT) was detected by radiolabelled fibrinogen uptake and bilateral venography was performed in patients who had a positive scan. In patients who had a negative scan, bilateral venography was performed routinely the day before discharge from hospital. The frequency of DVT demonstrated by venography was 4.9% in group A, 7.3% in group B and 10% in group C. The difference between the three groups was not statistically significant. The incidence of proximal DVT was 2.4, 2.4 and 7.5%, respectively, for the three groups. There was no significant difference between the three groups with respect to mean estimated blood loss, the number of blood units transfused, wound hematoma formation, or hemoglobin and hematocrit levels.
124例行全髋关节置换术的患者被随机分配接受以下治疗：卡比2165，2500抗Xa单位，每日两次（A组）；卡比2165，术后48小时内2500抗Xa单位，每日两次，之后5000抗Xa单位，每日一次（B组）；或根据活化部分凝血活酶时间调整剂量的标准肝素（C组）。三组均在手术前2小时给予首剂。通过放射性标记纤维蛋白原摄取检测深静脉血栓形成（DVT），对扫描阳性的患者进行双侧静脉造影。对于扫描阴性的患者，在出院前一天常规进行双侧静脉造影。静脉造影显示的DVT发生率在A组为4.9%，B组为7.3%，C组为10%。三组之间的差异无统计学意义。三组近端DVT的发生率分别为2.4%、2.4%和7.5%。三组在平均估计失血量、输血单位数、伤口血肿形成或血红蛋白和血细胞比容水平方面无显著差异。
