Heilmann L, Kruck M, Schindler A E
Stadtkrankenhaus Rüsselshein, Abteilung für Gynäkologie insbesondere gynäkologische Onkologie, Zentrum für Frauenheilkunde Essen.
Geburtshilfe Frauenheilkd. 1989 Sep;49(9):803-7. doi: 10.1055/s-2008-1036089.
The safety and efficacy of low molecular heparin (Sandoz AG, Nürnberg), given 1500 aPTT once daily (and two placebo injections), in preventing postoperative venous thromboembolism, was assessed against sodium heparin at a dose of 5000 IU three times daily, in a unicenter double-blind randomized study. 300 patients, scheduled for major gynecological surgery, were included in this study. Two patients (1.3%) of 150 patients developed deep vein thrombosis in the LMWH-group, the corresponding figure for sodium heparin was 6 patients (4.0%). There was no statistically significant difference between the two groups in respect to the bleeding variables such as postoperative drainage, blood transfusions and haematoma. The antithrombotic effects were assessed with the anti-Xa assay and LMWH-fractions have shown a high antifactor Xa/activated partial thromboplastin time (aPTT) specific activity (2:1) compared to unfractionated heparin (1:1). It is concluded that one single daily injection of LMWH (without dihydergot) provides a convenient safe and effective prophylaxis against thromboembolism in gynecological surgery.
在一项单中心双盲随机研究中，对低分子肝素（山德士公司，纽伦堡）每日一次给予1500 aPTT（以及两次安慰剂注射）预防术后静脉血栓栓塞的安全性和有效性，与每日三次给予5000 IU剂量的肝素钠进行了评估。300例计划进行大型妇科手术的患者纳入本研究。低分子肝素组150例患者中有2例（1.3%）发生深静脉血栓形成，肝素钠组相应数字为6例（4.0%）。两组在术后引流、输血和血肿等出血变量方面无统计学显著差异。通过抗Xa测定评估抗血栓形成作用，与普通肝素（1:1）相比，低分子肝素组分显示出高抗Xa/活化部分凝血活酶时间（aPTT）比活性（2:1）。得出结论：每日单次注射低分子肝素（不含双氢麦角胺）在妇科手术中提供了一种方便、安全且有效的血栓栓塞预防方法。
