Gruber U F, Saldeen T, Brokop T, Eklöf B, Eriksson I, Goldie I, Gran L, Hohl M, Jonsson T, Kristersson S, Ljungström K G, Lund T, Moe H M, Svensjö E, Thomson D, Torhorst J, Trippestad A, Ulstein M
Br Med J. 1980 Jan 12;280(6207):69-72. doi: 10.1136/bmj.280.6207.69.
A total of 4352 patients were admitted to a prospective' randomised multicentre trial comparing the prophylactic efficacy of dextran 70 and low-dose heparin against fatal pulmonary embolism after elective operations for general, orthopaedic, urological, and gynaecological conditions. Out of 3984 patients correctly admitted, 1993 were allocated to receive dextran 70 and 1991 to receive low-dose heparin. Withdrawal of prophylaxis because of bleeding or technical difficulties occurred more often in the heparin group, but allergic reactions were more common in the dextran group. Of the 75 patients who died within 30 days after operation, 38 had been given dextran and 37 low-dose heparin. Necropsy was performed in 33 and 32 of these cases respectively. In six patients in each group pulmonary embolism was the sole or a contributory cause of death. Of these, five patients in the dextran group and two in the heparin group had received a full course of prophylaxis. There was no statistically significant difference between the two treatment groups in the incidence of fatal pulmonary embolism after a full course of prophylaxis.
共有4352例患者被纳入一项前瞻性随机多中心试验，比较右旋糖酐70和小剂量肝素对普通外科、骨科、泌尿外科和妇科择期手术后致命性肺栓塞的预防效果。在3984例正确入组的患者中，1993例被分配接受右旋糖酐70，1991例接受小剂量肝素。由于出血或技术困难而停止预防措施的情况在肝素组更为常见，但过敏反应在右旋糖酐组更为普遍。在术后30天内死亡的75例患者中，38例接受了右旋糖酐治疗，37例接受了小剂量肝素治疗。分别对其中33例和32例进行了尸检。每组中有6例患者，肺栓塞是死亡的唯一原因或促成原因。其中，右旋糖酐组有5例患者、肝素组有2例患者接受了全程预防。在接受全程预防后，两个治疗组在致命性肺栓塞的发生率上没有统计学显著差异。
