Gurewich V, Nunn T, Kuriakose T T, Hume M
Arch Intern Med. 1978 Jan;138(1):41-4.
Two hours before surgery and every 12 hours thereafter 5,000 units of heparin sodium was administered subcutaneously to 100 general surgical patients. Hemostasis was evaluated by a template bleeding time and an activated partial thromboplastin time (PTT). The latter was sensitive to 0.05 units/ml of heparin and gave a straight-line response up to 0.2 units/ml. In the great majority of patients, only a modest elevation of the PTT occurred two and four hours after heparin therapy. However, in 10% to 15% the PTT was prolonged two times or more and in a similar number, PTT after surgery was shorter than baseline values despite heparin. No correlation between PTT prolongation and weight, ponderal index, age, or sex was found. Significant bleeding occurrred in three patients, two from the group of hyperresponders to heparin. Recent aspirin ingestion was implicated in one patient and our evidence indicates that low-dose heparin potentiates aspirin-induced prolongation of bleeding time in certain individuals. Local hematoma formation and discomfort from the injections was not a problem.
在手术前两小时以及此后每12小时，对100名普通外科患者皮下注射5000单位肝素钠。通过模板出血时间和活化部分凝血活酶时间（PTT）评估止血情况。后者对0.05单位/毫升的肝素敏感，在高达0.2单位/毫升时呈直线反应。在绝大多数患者中，肝素治疗后两小时和四小时仅出现PTT适度升高。然而，10%至15%的患者PTT延长两倍或更多，且类似比例的患者术后PTT尽管使用了肝素仍低于基线值。未发现PTT延长与体重、体重指数、年龄或性别之间存在相关性。三名患者出现严重出血，其中两名来自肝素高反应组。一名患者近期服用过阿司匹林，我们的证据表明低剂量肝素在某些个体中会增强阿司匹林诱导的出血时间延长。局部血肿形成和注射引起的不适不是问题。
