Stieger R, Gruber U F
Schweiz Med Wochenschr. 1981 May 16;111(20):716-22.
14 prospective, randomized trials dealing with non-operated patients were analyzed. In all of them the presence of deep vein thrombosis was measured by the radioactive iodine fibrinogen uptake test. Various prophylactic regimens were tested. 13 studies concern patients after myocardial infarction and one a cerebral hemorrhage patient. Only 2 trials confirm the value of oral couramin administration for the reduction of deep vein thrombosis after myocardial infarction. Two studies show that prophylactic anticoagulation with a full dose of heparin reduces the incidence of deep vein thrombosis after myocardial infarction. In 3 studies, again after myocardial infarction, a statistically significant reduction in the incidence of deep vein thrombosis is found when small doses of heparin are given. In 1 study investigating a few patients no effect could be shown. Low doses of heparin reduce the incidence of deep vein thrombosis after acute cerebral hemorrhage. Early mobilization has reduced the incidence of deep vein thrombosis in 21 patients after myocardial infarction, as compared to 8 patients treated with bed rest. Heavy smokers suffering myocardial infarction show a statistically significant lower incidence of deep vein thrombosis than non-smokers, as 3 papers confirm.
对14项针对非手术患者的前瞻性随机试验进行了分析。在所有这些试验中,通过放射性碘纤维蛋白原摄取试验来检测深静脉血栓形成的情况。测试了各种预防方案。13项研究涉及心肌梗死后的患者,1项涉及脑出血患者。只有2项试验证实口服香豆素对降低心肌梗死后深静脉血栓形成的价值。两项研究表明,全剂量肝素预防性抗凝可降低心肌梗死后深静脉血栓形成的发生率。在另外3项同样针对心肌梗死后患者的研究中,发现给予小剂量肝素时,深静脉血栓形成的发生率有统计学意义的降低。在1项对少数患者进行调查的研究中,未显示出效果。低剂量肝素可降低急性脑出血后深静脉血栓形成的发生率。与8例卧床休息治疗的患者相比,早期活动使21例心肌梗死后患者深静脉血栓形成的发生率降低。正如3篇论文所证实的,患心肌梗死的重度吸烟者深静脉血栓形成的发生率在统计学上显著低于非吸烟者。