Jones D P, Byrne P, Mackenzie R, Ameli F M, Provan J L
Can J Surg. 1984 Jan;27(1):15-6.
This randomized prospective study examines the efficacy of intravenously administered heparin as prophylaxis against deep-vein thrombosis, detected isotopically with iodine 125, in 37 patients scheduled to undergo major abdominal procedures. Twenty patients were given 5000 units of sodium heparin on opening the abdominal cavity, while 17 patients who did not receive heparin acted as controls. The effect of heparin was reversed at the end of the operative procedure by protamine. Three control patients had deep-vein thrombosis postoperatively but only one heparin-treated patient did. Complications in the treated group included excessive blood loss intraoperatively in one patient and an incisional hernia postoperatively in another. Although the results are not statistically significant, this study suggests that a single dose of heparin given intravenously during operation is a safe and effective means of prophylaxis against deep-vein thrombosis in patients who undergo general surgical procedures. Studies are now being carried out to determine the optimal dose of heparin, time of administration and duration of anticoagulation.
这项随机前瞻性研究检测了静脉注射肝素对37例计划接受腹部大手术患者预防深静脉血栓形成的效果，深静脉血栓形成采用碘125同位素检测。20例患者在打开腹腔时给予5000单位肝素钠，17例未接受肝素治疗的患者作为对照。手术结束时用鱼精蛋白逆转肝素的作用。3例对照患者术后发生深静脉血栓形成，但肝素治疗组仅1例发生。治疗组的并发症包括1例患者术中失血过多，另1例患者术后发生切口疝。虽然结果无统计学意义，但本研究提示，手术期间静脉注射单剂量肝素是预防接受普通外科手术患者深静脉血栓形成的一种安全有效的方法。目前正在进行研究以确定肝素的最佳剂量、给药时间和抗凝持续时间。
