Guyer R D, Booth R E, Rothman R H
J Bone Joint Surg Am. 1982 Sep;64(7):1040-4.
Because of the controversy surrounding prophylaxis for thromboembolism after total hip surgery, we undertook a prospective study comparing the results of the administration of aspirin with that of low doses of warfarin in 194 patients (200 hips) undergoing total hip replacement. The incidences of both clinically apparent and silent (asymptomatic) pulmonary emboli were determined using the objective criteria of preoperative and postoperative levels of arterial blood gases, chest roentgenograms, electrocardiograms, and perfusion lung scans. With this surveillance plan, the accuracy of diagnosis of clinically symptomatic pulmonary emboli was improved and the detection of otherwise silent pulmonary emboli became possible. The group of patients who received low doses of warfarin showed a 6 per cent total incidence of pulmonary emboli compared with a 19 per cent incidence in the group receiving aspirin (p less than 0.05). There was, however, no significant difference when the incidences of only the clinically suspected emboli were compared, the rates for the two groups being 5 and 8 per cent, respectively (p greater than 0.05). There was also no significant difference between men and women with regard to the prophylactic efficacy of aspirin in preventing pulmonary embolism.
由于全髋关节置换术后血栓栓塞预防措施存在争议，我们进行了一项前瞻性研究，比较了194例（200髋）接受全髋关节置换术患者服用阿司匹林与低剂量华法林的效果。采用术前和术后动脉血气水平、胸部X线片、心电图及肺灌注扫描等客观标准来确定临床明显及隐匿性（无症状）肺栓塞的发生率。通过这一监测方案，提高了临床症状性肺栓塞诊断的准确性，并使隐匿性肺栓塞的检测成为可能。接受低剂量华法林治疗的患者组肺栓塞总发生率为6%，而接受阿司匹林治疗的患者组发生率为19%（p<0.05）。然而，仅比较临床疑似栓塞的发生率时，两组无显著差异，分别为5%和8%（p>0.05）。在阿司匹林预防肺栓塞的疗效方面，男性和女性之间也没有显著差异。
