Urlep-Salinović V, Jelatancev B, Gorisek B
Department of Transfusiology and Immunohaematology, Teaching Hospital Maribor, Slovenia.
Thromb Haemost. 1994 Jul;72(1):16-20.
A prospective study of postoperative thromboembolic prophylaxis involving 500 gynaecological patients was performed to compare the effectiveness and safety of low doses of heparin (LDH) and heparin-dihydergot (HDHE). In the LDH group 255 patients (51%) aged 26-84 were included, in the HDHE group there were 245 patients (49%) aged 34-86. Both groups were well matched with respect to risk factors, duration of surgery, type of operation, volume of blood transfused and duration of prophylaxis. Thromboembolism was detected in 48 patients (9.6%): 26 patients (10.2%) in the LDH group and 22 patients (9%) in the HDHE group. In the LDH group isotopic deep vein thrombosis (DVT) was found in 23 patients (9%), five of them had pulmonary embolism (PE), detected by lung perfusion scanning without clinical signs of PE, three patients developed clinical PE without detected DVT. In the HDHE group, 22 patients (9%) had isotopic DVT and five of them had PE detected by lung perfusion scanning. In the incidence of TE there was no statistically significant difference between the two groups (p > 0.1). Within two months after surgery late clinically manifest TE confirmed by isotopic venography developed in five patients (1.9%) in the LDH group and in one patient (0.4%) in the HDHE group. Wound haematomas appeared in 8 patients (3.1%) in the LDH group and in 9 patients (3.7%) in the HDHE group. There were no ischemic complications (ergotism) in the HDHE group. The HDHE prophylaxis proved no more effective and was ten times more expensive than the usual prevention with LDH.
一项针对500例妇科患者的术后血栓栓塞预防的前瞻性研究，旨在比较低剂量肝素（LDH）和肝素 - 双氢麦角碱（HDHE）的有效性和安全性。LDH组纳入了255例年龄在26至84岁之间的患者（51%），HDHE组有245例年龄在34至86岁之间的患者（49%）。两组在危险因素、手术持续时间、手术类型、输血量和预防持续时间方面匹配良好。48例患者（9.6%）检测到血栓栓塞：LDH组26例患者（10.2%），HDHE组22例患者（9%）。在LDH组中，23例患者（9%）发现同位素深部静脉血栓形成（DVT），其中5例有肺栓塞（PE），通过肺灌注扫描检测到但无PE临床症状，3例患者出现临床PE但未检测到DVT。在HDHE组中，22例患者（9%）有同位素DVT，其中5例通过肺灌注扫描检测到有PE。两组在血栓栓塞（TE）发生率上无统计学显著差异（p>0.1）。术后两个月内，LDH组有5例患者（1.9%）经同位素静脉造影证实出现晚期临床表现的TE，HDHE组有1例患者（0.4%）出现。LDH组有8例患者（3.1%）出现伤口血肿，HDHE组有9例患者（3.7%）出现。HDHE组无缺血性并发症（麦角中毒）。事实证明，HDHE预防并不比LDH常规预防更有效，且成本高出十倍。
