Törngren S, Forsberg K
Acta Chir Scand. 1978;144(5):283-8.
A concentrated and a diluted heparin solution (Vitrum AB) have been evaluated in a controlled blind study, using a standard dosage of 5 000 IU, given every 12 hours subcutaneously. 167 patients undergoing abdominal surgery were randomized into three groups: 63 received diluted heparin 5 000 IU/ml, 43 received concentrated heparin 25 000 IU/ml and 61 patients served as controls. 80 per cent of the patients suffered from malignant disease. Deep venous thrombosis (DVT), diagnosed with the 125I-fibrinogen method, was found in 16% of the patients receiving diluted heparin, in 23% of those receiving concentrated heparin and in 33% of the controls. To evaluate the amount injected, an in vitro experiment was performed in which the intended dose was 5 000 IU. The measured amount of the concentrated heparin solution was significantly less than 5 000 IU. It is concluded that the frequency of DVT after gastrointestinal operations can be reduced significantly (in the present study from 33 to 16%) by administering diluted calcium heparin every 12 hours for 6--8 days. The concentrated heparin solution did not significantly reduce postoperative DVT, possibly on account of variations in the dosage. Diluted heparin prophylaxis can be achieved without serious side effects.
在一项对照双盲研究中，对一种浓缩肝素溶液和一种稀释肝素溶液（维特鲁姆公司生产）进行了评估，皮下注射标准剂量为每12小时5000国际单位。167例接受腹部手术的患者被随机分为三组：63例接受5000国际单位/毫升的稀释肝素，43例接受25000国际单位/毫升的浓缩肝素，61例患者作为对照。80%的患者患有恶性疾病。采用125I - 纤维蛋白原方法诊断深静脉血栓形成（DVT），结果显示，接受稀释肝素的患者中有16%发生DVT，接受浓缩肝素的患者中有23%发生DVT，对照组中有33%发生DVT。为评估注射量，进行了一项体外实验，预期剂量为5000国际单位。所测浓缩肝素溶液的量显著低于5000国际单位。结论是，通过每12小时给予稀释的肝素钙，持续6 - 8天，胃肠道手术后深静脉血栓形成的发生率可显著降低（在本研究中从33%降至16%）。浓缩肝素溶液未能显著降低术后深静脉血栓形成的发生率，可能是由于剂量差异所致。稀释肝素预防可在无严重副作用的情况下实现。
