Moskovitz P A, Ellenberg S S, Feffer H L, Kenmore P I, Neviaser R J, Rubin B E, Varma V M
J Bone Joint Surg Am. 1978 Dec;60(8):1065-70.
Sixty-seven hip-arthroplasty and fifty-two hip-fracture patients participated in a placebo-controlled randomized double-blind study on the effects of low-dose heparin prophylaxis in the prevention of venous thromboembolism. In this study, a positive thromboembolic event meant a positive test by: (1) daily 125I-fibrinogen scanning, (2) contrast venography on the tenth postoperative day, or (3) radionuclide perfusion lung scan in confirmation of suspected clinical pulmonary emboli. Nineteen (59.4 per cent) of thirty-two placebo-treated arthroplasty patients showed evidence of a thromboembolic event in contrast with eight (22.9 per cent) of thirty-five heparin-treated patients (p less than 0.003). Heparin-treated arthroplasty patients required mean blood transfusions of 4.7 units, contrasted with a mean 3.2-unit transfusion requirement for placebo-treated patients (p less than 0.05). The incidence of observed bleeding complications was higher among the heparin-treated patients. Of the twenty-three placebo-treated patients with fracturs, 39.1 per cent had a thromboembolic event, while 41.4 per cent of the twenty-nine who received heparin showed evidence of thromboembolism, demonstrating that low-dose heparin afforded no protection, nor did it affect the incidence of bleeding complications or transfusion requirements in fracture patients.
67名髋关节置换患者和52名髋部骨折患者参与了一项关于低剂量肝素预防静脉血栓栓塞作用的安慰剂对照随机双盲研究。在该研究中，阳性血栓栓塞事件指通过以下方式检测呈阳性：（1）每日进行¹²⁵I-纤维蛋白原扫描，（2）术后第10天进行静脉造影，或（3）放射性核素灌注肺扫描以确诊疑似临床肺栓塞。32名接受安慰剂治疗的置换患者中有19名（59.4%）出现血栓栓塞事件迹象，相比之下，35名接受肝素治疗的患者中有8名（22.9%）出现此类迹象（p<0.003）。接受肝素治疗的置换患者平均需要输血4.7单位，而接受安慰剂治疗的患者平均输血需求量为3.2单位（p<0.05）。肝素治疗组患者中观察到的出血并发症发生率更高。在23名接受安慰剂治疗的骨折患者中，39.1%发生了血栓栓塞事件，而在29名接受肝素治疗的患者中，41.4%出现了血栓栓塞迹象，这表明低剂量肝素没有起到预防作用，也未影响骨折患者的出血并发症发生率或输血需求量。
