Mant M J, O'Brien B D, Thong K L, Hammond G W, Birtwhistle R V, Grace M G
Lancet. 1977 May 28;1(8022):1133-5. doi: 10.1016/s0140-6736(77)92388-1.
In a prospective trial 76 patients with venous thromboembolism have received intermittent constant-dosage heparin or continuously infused heparin with laboratory control. Frequencies of bleeding were similar in both groups. 32% of all patients bled, 13% severely. Retroperitoneal haemorrhage occurred in 5 patients. Major spontaneous bleeding was commoner in older patients and minor spontaneous bleeding in women. Bleeding was uncommon during the first 2 days of treatment, and its daily frequency was relatively constant thereafter. 21% of surgical wounds and 7% of arterial and venous puncture sites bled. These preliminary results illustrate the hazards of heparin therapy and suggest that bleeding complications are more closely related to duration of therapy, age, sex, and surgical trauma than to method of administration.
在一项前瞻性试验中，76例静脉血栓栓塞患者接受了间歇恒量肝素治疗或持续输注肝素治疗，并进行实验室监测。两组的出血频率相似。所有患者中有32%发生出血，13%为严重出血。5例患者出现腹膜后出血。老年患者主要自发性出血较为常见，女性则以轻微自发性出血为主。治疗的头两天出血情况不常见，此后每日出血频率相对恒定。21%的手术伤口和7%的动静脉穿刺部位发生出血。这些初步结果说明了肝素治疗的风险，并表明出血并发症与治疗持续时间、年龄、性别和手术创伤的关系比与给药方法更为密切。
