Onarheim H, Lund T, Heimdal A, Arnesjø B
Acta Chir Scand. 1986 Oct;152:593-6.
In a prospective double-blind trial, low molecular weight (LMW) heparin (KABI 2165) 5,000 U (anti-Xa) once daily was compared with conventional heparin 5,000 IU twice daily, both given subcutaneously, as regards prevention of postoperative deep venous thrombosis (DVT) in 52 patients undergoing major abdominal surgery. Radioactive fibrinogen uptake test (FUT) was used for DVT screening. DVT, diagnosed from positive FUT, developed in two patients from each group, but could be phlebographically confirmed in only one (LMW) case. No intergroup differences were found in peroperative blood loss or requirements for blood transfusion. Complications attributable to the prophylactic regimens were few. In the LMW-heparin group, the anti-Xa levels measured during operation showed considerable variation, the higher activities (greater than 0.30 U/ml) being nonsignificantly associated with increased blood loss. Studies with lower doses of LMW-heparin are recommended.
在一项前瞻性双盲试验中,将5000单位(抗Xa)的低分子量(LMW)肝素(KABI 2165)每日一次与5000国际单位的传统肝素每日两次进行比较,二者均皮下注射,用于预防52例接受腹部大手术患者的术后深静脉血栓形成(DVT)。采用放射性纤维蛋白原摄取试验(FUT)进行DVT筛查。每组各有两名患者FUT呈阳性,被诊断为DVT,但仅1例(LMW组)经静脉造影得以证实。两组患者术中失血量或输血需求方面未发现组间差异。预防性治疗方案引起的并发症较少。在LMW肝素组,术中测得的抗Xa水平显示出相当大的差异,较高活性(大于0.30 U/ml)与失血量增加之间的关联无统计学意义。建议开展低剂量LMW肝素的研究。