Breddin H K
Abteilung für Angiologie, Johann-Wolfgang-von-Goethe-Universität, Frankfurt, BRD.
Wien Med Wochenschr. 1989 Dec 15;139(23):555-9.
2 or 3 daily injections of unfractionated heparin reduce the risk of thrombosis in patients undergoing general surgery from about 39 to 4 to 5% (sodium-fibrinogen-test). In patients at high risk (hip replacement, knee operations) a thrombosis incidence of about 20% is observed even under heparin prophylaxis. The clinical incidence of venous thrombosis is reduced to less than 1% in patients undergoing general surgery. Low molecular weight heparins have been investigated in a number of clinical trials. A single daily s.c. injection of low molecular weight heparin is as effective or more effective than 2 to 3 daily s.c. injections of unfractionated heparins in the prevention of thromboses in general surgery. The bleeding risk is not reduced compared to unfractionated heparin. Most frequent side effects of heparin prophylaxis are bleeding complications followed by thrombocytopenia between 1 to 2% and the rare but dangerous "white-clot-syndrome" (less than 0.01%). Some patients with thrombocytopenia or white-clot-syndrome can be successfully treated with a low molecular weight heparin fraction.
每日注射2至3次普通肝素可将接受普通外科手术患者的血栓形成风险从约39%降至4%至5%（纤维蛋白原钠试验）。在高危患者（髋关节置换、膝关节手术）中，即使进行肝素预防，血栓形成发生率仍约为20%。接受普通外科手术患者的静脉血栓临床发生率降至1%以下。低分子量肝素已在多项临床试验中进行了研究。在普通外科手术中预防血栓形成方面，每日皮下注射一次低分子量肝素与每日皮下注射2至3次普通肝素同样有效或更有效。与普通肝素相比，出血风险并未降低。肝素预防最常见的副作用是出血并发症，其次是1%至2%的血小板减少症，以及罕见但危险的“白色血栓综合征”（低于0.01%）。一些血小板减少症或白色血栓综合征患者可用低分子量肝素片段成功治疗。
