Lowe G D, Campbell A F, Meek D R, Forbes C D, Prentice C R
Lancet. 1978 Sep 30;2(8092 Pt 1):698-700. doi: 10.1016/s0140-6736(78)92701-0.
In a randomised double-blind controlled trial 53 patients received 5 daily subcutaneous injections of ancrod ('Arvin') after operation for fractured neck of femur, and 52 patients received saline fractured neck of femur, and 52 patients received saline injections. Deep-vein thrombosis (D.V.T.) was detected by bilateral ascending venography or necropsy 6--16 days after surgery. The frequency of D.V.T. and bilateral D.V.T. was significantly lower in the ancrod group (P less than 0.01). The frequency of major D.V.T. (thrombi in veins proximal to the calf, or calf-vein thrombi more than 3 cm long) was also significantly lower in the ancrod group (P less than 0.001). No complications of ancrod prophylaxis occurred. Ancrod reduced plasma-fibrinogen, and hence plasma and blood viscosity, during the first week after surgery; preoperative levels of fibrinogen and viscosity were not associated with post-operative D.V.T. Subcutaneous ancrod is a simple and effective alternative to oral anticoagulants for the reduction of the frequency of D.V.T. after operation for hip fracture, and merits assessment in other high-risk groups of patients.
在一项随机双盲对照试验中，53例股骨颈骨折术后患者每日皮下注射5次抗栓酶（“Arvin”），52例股骨颈骨折患者注射生理盐水，另有52例患者注射盐水。术后6 - 16天通过双侧上行静脉造影或尸检检测深静脉血栓形成（D.V.T.）。抗栓酶组的D.V.T.和双侧D.V.T.发生率显著较低（P小于0.01）。抗栓酶组主要D.V.T.（小腿近端静脉血栓或长度超过3 cm的小腿静脉血栓）的发生率也显著较低（P小于0.001）。未发生抗栓酶预防的并发症。抗栓酶在术后第一周降低了血浆纤维蛋白原，从而降低了血浆和血液粘度；术前纤维蛋白原和粘度水平与术后D.V.T.无关。皮下注射抗栓酶是口服抗凝剂的一种简单有效的替代方法，可降低髋部骨折术后D.V.T.的发生率，值得在其他高危患者群体中进行评估。
