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[药物预防中血栓栓塞的死亡率和发病率——5年分析]

[Mortality and morbidity of thromboembolism in drug prevention--5-year analysis].

作者信息

Hopp H, Hopp A, Knispel J

机构信息

Frauenklinik, Bezirkskrankenhauses, Stralsund.

出版信息

Zentralbl Gynakol. 1988;110(9):562-9.

PMID:3407358
Abstract

In a period of five years a general medical prevention of postoperative venous thromboembolic disease was tested in major gynaecological operations, in patients undergoing radium insertions for gynaecological cancer and in patients with caesarean section. Preoperatively was the beginning of the daily therapy with Dihydroergotamine (DHE) and every four days the therapy with Acetylsalicylic acid (ASS). The results of 2,346 therapy-cycles with medical prevention of thromboembolic disease in 2,280 patients are reported. Risks of thromboembolic disease were in 63% of the gynaecologic patients (mean age 52.4 +/- 8.9 years) and in 34% of the obstetrical patients (mean age 24.6 +/- 5.1 years). Postoperative bleeding complications occurred in 12 cases (0.5%) and the number of reoperations was lower than 1 0/00). Postoperative thromboembolic complications were found clinically and radiologically in 0.3% of the patients. Letal embolism of the lung happened in 2 patients (0.9 0/00). A general medical prevention of thromboembolic disease with DHE and ASS can be recommended because of the low rate of postoperative bleeding complications and of the reduced rate of postoperative thromboembolic disease. A prevention of thromboembolic disease by individual dosage of heparin must be considered in patients at high risk for thromboembolic disease.

摘要

在五年时间里,对接受大型妇科手术、因妇科癌症接受镭植入治疗的患者以及剖宫产患者进行了术后静脉血栓栓塞性疾病的一般药物预防试验。术前开始每日使用双氢麦角胺(DHE)治疗,每四天使用乙酰水杨酸(ASS)治疗。报告了2280例患者进行2346个周期血栓栓塞性疾病药物预防治疗的结果。妇科患者(平均年龄52.4±8.9岁)中63%存在血栓栓塞性疾病风险,产科患者(平均年龄24.6±5.1岁)中34%存在该风险。术后出血并发症发生12例(0.5%),再次手术率低于1‰。0.3%的患者出现临床和影像学诊断的术后血栓栓塞并发症。2例患者发生致命性肺栓塞(0.9‰)。鉴于术后出血并发症发生率低以及术后血栓栓塞性疾病发生率降低,推荐使用DHE和ASS进行血栓栓塞性疾病的一般药物预防。对于血栓栓塞性疾病高风险患者,必须考虑通过个体化剂量肝素预防血栓栓塞性疾病。

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