Kakkar V V
Nouv Rev Fr Hematol (1978). 1984;26(4):277-82.
The efficacy of low molecular weight heparin (LMW heparin) was assessed in 550 patients over the age of 40 years, undergoing a variety of elective major surgical procedures. LMW heparin fraction (CY 216, Choay Laboratories, Paris) was used in this study. Each patient received a single injection of 1,850 APTT units of LMW heparin 2 h before surgery, and the same dose was repeated daily for at least 7 days post-operation. Fibrinogen uptake test and ventilation perfusion lung scanning were used to confirm the presence of thromboemboli. Of 501 patients in whom the protocol had been accurately followed, 17 (3.4%) developed DVT, in none were thrombi bilateral. 22 (4.4%) died during the post-operative period. In none of the autopsied patients could emboli be demonstrated. Blood loss during surgery was considered to be excessive in 32 (6.4%). In 19 (3.8%), subcutaneous haematoma developed at the site of abdominal incision. The data presented in this paper indicates that a single daily injection of 1,850 APTT units of LMW heparin is a convenient and safe methods of preventing post-operative venous thromboembolic complications in patients undergoing major abdominal surgery.
对550例40岁以上接受各种择期大手术的患者评估了低分子量肝素（LMW肝素）的疗效。本研究使用了LMW肝素制剂（CY 216，法国巴黎Choay实验室生产）。每位患者在手术前2小时接受一次1850 APTT单位的LMW肝素注射，术后至少7天每天重复相同剂量。采用纤维蛋白原摄取试验和通气灌注肺扫描来确认是否存在血栓栓塞。在501例严格遵循方案的患者中，17例（3.4%）发生了深静脉血栓形成（DVT），无一例血栓为双侧性。22例（4.4%）在术后期间死亡。在所有尸检患者中均未发现栓子。32例（6.4%）患者术中失血过多。19例（3.8%）患者腹部切口部位出现皮下血肿。本文所呈现的数据表明，每天单次注射1850 APTT单位的LMW肝素是预防接受腹部大手术患者术后静脉血栓栓塞并发症的一种方便且安全的方法。
