Zanasi R, Fioretta G, Ciocia G, Bergonzi M
Orthopedics Department, Fatebenefratelli Hospital, Milan, Italy.
Clin Ther. 1988;10(4):350-7.
The effectiveness of defibrotide was compared with that of calcium heparin and acetylsalicylic acid (ASA) in the prevention of deep venous thrombosis (DVT) resulting from orthopedic surgery. Sixty-three patients scheduled for elective or traumatological surgery, for the most part involving the hip joint, were recruited. The patients were randomly assigned to one of the following treatment groups: defibrotide (400 mg twice daily), administered intramuscularly (n = 19); calcium heparin (5,000 IU thrice daily), administered subcutaneously (n = 25); and ASA (100 mg on alternate days), administered orally (n = 19). Administration of the drug was started one day before surgery and continued until the seventh day after surgery. Each patient was monitored daily by means of the fibrinogen uptake test. The incidence of increased uptake did not differ significantly in the three groups (defibrotide, ten out of 19; calcium heparin, ten out of 25; ASA, seven out of 19). Conversely, a trend in favor of defibrotide was noted in cases of symptomatic DVT (defibrotide, one out of 19; calcium heparin, two out of 25; ASA, four out of 19) and pulmonary embolism (defibrotide, no cases; calcium heparin, one case; ASA two cases). On the strength of these findings, defibrotide therapy qualifies as a valid alternative to conventional DVT prophylaxis in orthopedic surgery.
将去纤苷与肝素钙和乙酰水杨酸（ASA）在预防骨科手术引起的深静脉血栓形成（DVT）方面的有效性进行了比较。招募了63例计划进行择期手术或创伤手术的患者，大部分手术涉及髋关节。患者被随机分配到以下治疗组之一：去纤苷（每日两次，每次400mg），肌肉注射（n = 19）；肝素钙（每日三次，每次5000IU），皮下注射（n = 25）；以及ASA（隔日100mg），口服（n = 19）。药物在手术前一天开始给药，并持续至手术后第七天。通过纤维蛋白原摄取试验对每位患者进行每日监测。三组中摄取增加的发生率无显著差异（去纤苷组，19例中有10例；肝素钙组，25例中有10例；ASA组，19例中有7例）。相反，在有症状的DVT病例（去纤苷组，19例中有1例；肝素钙组，25例中有2例；ASA组，19例中有4例）和肺栓塞病例（去纤苷组，无病例；肝素钙组，1例；ASA组，2例）中，发现了有利于去纤苷的趋势。基于这些发现，去纤苷治疗可作为骨科手术中传统DVT预防的有效替代方案。
