Balderston R A, Graham T S, Booth R E, Rothman R H
Thomas Jefferson University, Philadelphia, Pennsylvania.
J Arthroplasty. 1989 Sep;4(3):217-21. doi: 10.1016/s0883-5403(89)80017-8.
The efficacy of low-dose warfarin therapy for prophylaxis of venous thromboembolic disease was studied prospectively in a group of 1,392 patients undergoing cemented total hip arthroplasty between 1978 and 1985. The incidence of both symptomatic and asymptomatic pulmonary emboli was determined after surgery in all patients using ventilation-perfusion lung scanning as the diagnostic endpoint. The total incidence of postoperative pulmonary embolus was 3.2%, with two-thirds asymptomatic and one-third symptomatic pulmonary emboli. There were no fatalities due to pulmonary embolism in the entire patient population. Bleeding complications requiring surgical intervention developed in 2.4% of patients. The authors conclude that low-dose warfarin therapy is a safe and easily administered form of inpatient treatment for prophylaxis of venous thromboembolic disease in all total hip arthroplasty patients and has demonstrated complete protection against fatal pulmonary embolism in this population.
1978年至1985年间，对一组1392例行骨水泥型全髋关节置换术的患者进行了前瞻性研究，以评估低剂量华法林预防静脉血栓栓塞性疾病的疗效。术后采用通气灌注肺扫描作为诊断终点，测定所有患者有症状和无症状肺栓塞的发生率。术后肺栓塞的总发生率为3.2%，其中三分之二为无症状肺栓塞，三分之一为有症状肺栓塞。在整个患者群体中，无因肺栓塞导致的死亡病例。2.4%的患者出现了需要手术干预的出血并发症。作者得出结论，低剂量华法林治疗是一种安全且易于实施的住院治疗方式，可用于预防所有全髋关节置换术患者的静脉血栓栓塞性疾病，并且在该人群中已证明能完全预防致命性肺栓塞。
