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术前小剂量肝素、前列腺切除术与临床肺血栓栓塞症

Preoperative mini-heparin, prostatectomy and clinical pulmonary thromboembolism.

作者信息

Miller E V, Butz G W

出版信息

Int Surg. 1981 Apr-Jun;66(2):155-6.

PMID:6168599
Abstract

From February 1973 through May 1977, a selected group of 131 patients undergoing prostatectomy were given preoperative mini-heparin 6--8 hours prior to surgery. There were 17 retropubic prostatectomies, 1 subtotal suprapubic prostatectomy and 113 transurethral prostatic resections. Patients ages ranged from 35 to 108 years. There were 109 cases of benign prostatic hyperplasia, 13 cases of adenocarcinoma of the prostate and 9 cases of benign prostatic hyperplasia with foci of adenocarcinoma. There was one death from massive pulmonary thromboembolism and one case of non-fatal pulmonary thromboembolism. A retrospective review of 416 prostatectomies performed during the same period of time at the same hospital, in which mini-heparin was not administered preoperatively, revealed only one case of non-fatal pulmonary thromboembolism. Our study indicates that this preoperative mini-heparin regime did not effectively reduce the morbidity and mortality associated with clinical postoperative thromboembolic phenomena. There were no important side effects, such as prolonged bleeding or drug intolerance, associated with the administration of preoperative mini-heparin.

摘要

1973年2月至1977年5月,一组经过挑选的131例接受前列腺切除术的患者在手术前6 - 8小时给予小剂量肝素。其中有17例耻骨后前列腺切除术、1例耻骨上前列腺次全切除术和113例经尿道前列腺切除术。患者年龄在35岁至108岁之间。有109例良性前列腺增生、13例前列腺腺癌以及9例伴有腺癌灶的良性前列腺增生。有1例因大面积肺血栓栓塞死亡,1例非致命性肺血栓栓塞。对同一医院同期进行的416例未在术前给予小剂量肝素的前列腺切除术进行回顾性研究发现,仅1例非致命性肺血栓栓塞。我们的研究表明,这种术前小剂量肝素方案并不能有效降低与临床术后血栓栓塞现象相关的发病率和死亡率。术前给予小剂量肝素未出现诸如出血时间延长或药物不耐受等重要副作用。

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