Harenberg J
I. Medizinische Klinik, Fakultät für Klinische Medizin Mannheim, Universität Heidelberg.
Z Kardiol. 1993;82 Suppl 2:71-5.
The use of heparins is established in the treatment of recent deep vein thrombosis, when contraindications for thrombectomy or thrombolytic therapy are present. Recent data indicate that twice daily subcutaneous administration of unfractionated heparin is almost as effective and safe as the continuous intravenous infusion. Detailed analysis of the randomized prospective and phlebographic controlled studies indicate that the subcutaneous administration is even somewhat more effective and especially safer. The higher safety refers to a lower incidence of moderate and severe bleeding complications as well as to local infections due to the continuous intravenous infusion. The phlebographic investigations demonstrate that the Marder Score is improved in 50-60% of heparinized patients. Complete thrombolysis is obtained in about 10% of patients. These results are better than those reported between 1950 and 1969. It is concluded that heparins exert some thrombolytic effects in recent deep vein thrombosis and that subcutaneous administration is almost as effective and safe as intravenous continuous infusion.
在存在血栓切除术或溶栓治疗禁忌证的情况下，肝素已被用于近期深静脉血栓形成的治疗。近期数据表明，每日两次皮下注射普通肝素几乎与持续静脉输注一样有效且安全。对随机前瞻性和静脉造影对照研究的详细分析表明，皮下给药甚至在某种程度上更有效，且尤其更安全。更高的安全性是指中度和重度出血并发症以及因持续静脉输注导致的局部感染发生率更低。静脉造影检查表明，50%至60%接受肝素治疗的患者的马德评分有所改善。约10%的患者实现了完全溶栓。这些结果优于1950年至1969年期间报告的结果。得出的结论是，肝素在近期深静脉血栓形成中发挥一些溶栓作用，并且皮下给药几乎与静脉持续输注一样有效且安全。
