Kakkar V V, Djazaeri B, Fok J, Fletcher M, Scully M F, Westwick J
Br Med J (Clin Res Ed). 1982 Feb 6;284(6313):375-9. doi: 10.1136/bmj.284.6313.375.
The efficacy of low-molecular-weight heparin as a prophylactic agent was assessed in 150 consecutive patients over the age of 40 undergoing major abdominal surgery. Fifty of these patients received 1250 activated partial thromboplastin time (APTT) units of low-molecular-weight heparin every 12 hours: three developed isotopic deep vein thrombosis, which was confirmed by phlebography in two cases. The other 100 patients received a single injection of 1850 APTT units of low-molecular-weight heparin. Three of them developed isotopic deep vein thrombosis; phlebography failed to confirm the presence of thrombi in each case. None of the 150 patients studied died from fatal or contributory pulmonary emboli. Low-molecular-weight heparin was not associated with any increase in preoperative or postoperative bleeding. The effect of equal amounts of postoperative bleeding. The effect of equal amounts of low-molecular-weight heparin and unfractionated heparin on the coagulation mechanism during surgery was investigated in another 30 patients. The clotting assays and results of in-vivo platelet function tests indicated that both preparations produced similar effect. Intragroup comparisons, however, showed significant differences in the anti-factor Xa activity, lipoprotein lipase release, and plasma prekallikrein concentrations. A single injection of low-molecular-weight heparin daily is a convenient way of preventing deep vein thrombosis in high-risk patients undergoing major abdominal surgery.
对150例年龄超过40岁接受腹部大手术的连续患者评估了低分子量肝素作为预防剂的疗效。其中50例患者每12小时接受1250活化部分凝血活酶时间（APTT）单位的低分子量肝素：3例发生同位素深部静脉血栓形成，其中2例经静脉造影证实。另外100例患者单次注射1850 APTT单位的低分子量肝素。其中3例发生同位素深部静脉血栓形成；静脉造影未能在每个病例中证实血栓的存在。研究的150例患者中无一例死于致命性或促成性肺栓塞。低分子量肝素与术前或术后出血增加无关。等量术后出血的影响。在另外30例患者中研究了等量低分子量肝素和普通肝素对手术期间凝血机制的影响。凝血试验和体内血小板功能测试结果表明，两种制剂产生相似的效果。然而，组内比较显示抗Xa因子活性、脂蛋白脂肪酶释放和血浆前激肽释放酶浓度存在显著差异。对于接受腹部大手术的高危患者，每日单次注射低分子量肝素是预防深部静脉血栓形成的便捷方法。
