Zajtchuk R, Collins G J, Schuchmann G F, Holley P W, Hamaker W R
J Thorac Cardiovasc Surg. 1978 Feb;75(2):168-70.
One hundred patients were screened for hypercoagulability preoperatively and on the third, seventh, tenth, fourteenth, and twenty-first days postoperatively. Patients found to have hypercoagulability were treated with heparin, aspirin, and Coumadin. When the abnormality was present preoperatively, treatment was continued for the duration of the patient's life. Those patients in whom abnormalities developed postoperatively were given anticoagulants until cardiac catheterization 6 months following their operation. Twenty-four of the 100 patients had no coagulation abnormalities preoperatively or postoperatively. Fifteen patients were found to have abnormality prior to operation. Their predominant abnormality was low antithrombin III activity. Sixty-one patients became hypercoagulable postoperatively. Predominant abnormality in this group of patients was increased thrombin generation and increased platelet adhesiveness. Evaluation of patients in this study group revealed a decrease in the incidence of pulmonary embolism, an increase in the patency of vein grafts, and the elimination of anticoagulant therapy in 24 percent of the patients.
对100例患者在术前以及术后第3天、第7天、第10天、第14天和第21天进行高凝状态筛查。发现有高凝状态的患者用肝素、阿司匹林和香豆素进行治疗。如果术前就存在异常情况，则在患者的余生持续进行治疗。那些术后出现异常情况的患者给予抗凝剂治疗，直至术后6个月进行心导管检查。100例患者中有24例术前和术后均无凝血异常。15例患者在手术前被发现有异常。他们最主要的异常是抗凝血酶III活性降低。61例患者术后出现高凝状态。该组患者最主要的异常是凝血酶生成增加和血小板黏附性增加。对该研究组患者的评估显示，肺栓塞的发生率降低，静脉移植物的通畅率提高，并且24%的患者不再需要抗凝治疗。
