Borghi B, Bassi A, Grazia M, Feoli M A, Pignotti E
I Servizio di Anestesia e Rianimazione, IRCCS Istituti Ortopedici Rizzoli, Bologna.
Minerva Anestesiol. 1996 Mar;62(3):93-100.
Evaluation of incidence of postoperative thrombotic and haemorrhagic complications in autotrasfused patients undergoing blood predepositing, hemodilution, intra and postoperative blood saving and treated with indobufen, heparin calcine and low molecular weight heparin (enoxeparin).
Comparative study. Length of follow up: 6 months.
Three division of Orthopaedic Surgery related to 1st Anaesthesiology and Intensive Care Unit of Rizzoli Orthopaedic Institute.
980 consecutive patients admitted to hospital from 1-1-1992 to 30-6-1994 (321 males and 159 females), aged between 20 and 90 years (mean 62 +/- 11 years), with basal hemoglobin at 13.4 +/- 1.4 g/dI (range 6.7-17.9), who had undergone antithromboembolic prophylaxis with indobufen (Indo, 668), heparin calcine (CaHe, 200) and low molecular weight heparin (LMWH).
Total hip (714) and knee (121) arthroprosthesis and hip replacements (cup 33, stem 10, cup and stem 102).
The incidence of death, thromboembolic complications (pulmonary embolism, deep vein thrombosis), hemorrhage (hematoma and homologous transfusions), cardiac ischaemia. ANOVA and contingency tables (CT) were used for statistical.
The absence of complications was significantly greater in patients treated with indobufen (Indo 94.3% vs CaHe 83.5% vs LMWH 85.7%, CT: p = 0.0001); the incidence of thromboembolic complications was significantly higher in patients treated with heparin calcine and low molecular weight heparin; in patients treated with heparin calcine the incidence of haemorrhagic complications was significantly higher. Due to bleeding brought about by the use of heparin calcine, one patient with coronary heart disease suffered from anemia and severe hypotensions by myocardiac infarction and cardiogenous shock which led to the patient's death. The use of homologous transfusions was significantly higher in patients treated with heparin calcine (Indo 4.2% vs CaHe 14.5% vs LMWH 4.5%, CT: p = 0.0001).
In patients undergoing autotransfusion and hemodilution, indobufen has a lower of haemorrhagic complications compared to heparine calcine and low molecular weight heparin and it is more effective in the prevention of thrombotic complications at clinical evidence.
评估自体输血患者在进行血液预存、血液稀释、术中及术后血液回收并接受吲哚布芬、钙肝素和低分子肝素（依诺肝素）治疗后发生术后血栓形成和出血并发症的发生率。
对比研究。随访时长：6个月。
里佐利骨科研究所第一麻醉与重症监护科下属的三个骨外科科室。
1992年1月1日至1994年6月30日连续入院的980例患者（男性321例，女性159例），年龄在20至90岁之间（平均62±11岁），基础血红蛋白为13.4±1.4g/dl（范围6.7 - 17.9），这些患者接受了吲哚布芬（Indo，668例）、钙肝素（CaHe，200例）和低分子肝素（LMWH）的抗血栓栓塞预防治疗。
全髋关节置换术（714例）、膝关节置换术（121例）以及髋关节翻修术（髋臼33例、股骨柄10例、髋臼和股骨柄102例）。
死亡率、血栓栓塞并发症（肺栓塞、深静脉血栓形成）、出血（血肿和异体输血）、心脏缺血。采用方差分析和列联表（CT）进行统计学分析。
接受吲哚布芬治疗的患者无并发症的比例显著更高（Indo为94.3%，CaHe为83.5%，LMWH为85.7%，CT：p = 0.0001）；接受钙肝素和低分子肝素治疗的患者血栓栓塞并发症的发生率显著更高；接受钙肝素治疗的患者出血并发症的发生率显著更高。由于使用钙肝素导致出血，一名冠心病患者因心肌梗死和心源性休克出现贫血和严重低血压，最终死亡。接受钙肝素治疗的患者异体输血的使用率显著更高（Indo为4.2%，CaHe为14.5%，LMWH为4.5%，CT：p = 0.0001）。
在接受自体输血和血液稀释的患者中，与钙肝素和低分子肝素相比，吲哚布芬的出血并发症发生率更低，且在临床证据上预防血栓形成并发症更有效。
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