Bergqvist D, Mätzsch T, Burmark U S, Frisell J, Guilbaud O, Hallböök T, Horn A, Lindhagen A, Ljungnér H, Ljungström K G
Department of Surgery, General Hospital, Malmö, Sweden.
Br J Surg. 1988 Sep;75(9):888-91. doi: 10.1002/bjs.1800750920.
A prospective randomized double-blind trial was performed comparing conventional low-dose heparin with a low molecular weight heparin fragment for thromboprophylaxis in elective general abdominal surgical patients. The first dose of the heparin fragment was given the evening before surgery, and further doses were given thereafter every evening. There were 1002 analysable patients, 826 having received correct prophylaxis. Of these 1002 patients, 64 per cent were operated on for malignant disease. A total of 20 patients died, 10 in each group. The frequency of deep vein thrombosis was significantly reduced among patients with correct prophylaxis with the heparin fragment (9.2-5.0 per cent, P = 0.02) [corrected]. The frequency of bleeding was 6.7 per cent among the heparin fragment patients and 2.7 per cent among the patients given conventional heparin (P = 0.01), but all bleeds were of minor degree and there was no difference in the reoperation rate for bleeding, or in the transfusion requirements. Local pain at the injection site was reported significantly less often among patients given the heparin fragment.
开展了一项前瞻性随机双盲试验，比较传统低剂量肝素与一种低分子量肝素片段在择期普通腹部外科手术患者中预防血栓形成的效果。肝素片段的首剂于手术前一晚给药，此后每晚给药。共有1002例可分析患者，其中826例接受了正确的预防措施。在这1002例患者中，64%因恶性疾病接受手术。共有20例患者死亡，每组各10例。接受肝素片段正确预防的患者中深静脉血栓形成的发生率显著降低（9.2% - 5.0%，P = 0.02）[校正后]。肝素片段组患者的出血发生率为6.7%，接受传统肝素治疗的患者为2.7%（P = 0.01），但所有出血均程度较轻，出血后再次手术率或输血需求方面无差异。接受肝素片段治疗的患者报告注射部位局部疼痛的情况明显较少。
