Cade J F, Clegg E A, Westlake G W
Aust N Z J Surg. 1983 Aug;53(4):301-4. doi: 10.1111/j.1445-2197.1983.tb02451.x.
The high incidence (50-60%) of deep venous thrombosis of the legs (DVT) after major thoracic surgery is reduced only by about half with routine low-dose heparin prophylaxis. The present study compared the efficacy of a higher dose of heparin (7500 U twice daily) with the commonly used dose of 5000 U twice daily in preventing scan-detected DVT in 100 consecutive patients having thoracotomy for carcinoma of the lung or oesophagus. After the higher dose of heparin, postoperative DVT was not significantly less frequent (22% compared with 33% for total DVT) but was significantly less extensive (8% and 14%, respectively, for bilateral calf DVT, and 0% and 4% for popliteal DVT). Despite prophylaxis, DVT was especially common after oesophagogastrectomy (41% total DVT, 30% extensive DVT). No excessive postoperative bleeding was noted in either group. It is concluded that an increased dose of heparin safely offers increased prophylaxis against DVT in patients undergoing major thoracic surgery for cancer.
在胸科大手术后，腿部深静脉血栓形成（DVT）的发生率很高（50 - 60%），而常规低剂量肝素预防只能将其降低约一半。本研究比较了高剂量肝素（每日两次，每次7500单位）与常用剂量（每日两次，每次5000单位）在预防100例因肺癌或食管癌行开胸手术患者经扫描检测到的DVT方面的疗效。使用高剂量肝素后，术后DVT的发生频率虽无显著降低（总DVT发生率分别为22%和33%），但范围显著减小（双侧小腿DVT分别为8%和14%，腘静脉DVT分别为0%和4%）。尽管进行了预防，DVT在食管胃切除术后尤其常见（总DVT发生率为41%，广泛性DVT发生率为30%）。两组均未发现术后出血过多的情况。结论是，增加肝素剂量可安全地增强对接受癌症胸科大手术患者DVT的预防作用。
