Nilsson P E, Bergqvist D, Benoni G, Björgell O, Fredin H, Hedlund U, Nicolas S, Nylander G
Department of Diagnostic Radiology, Malmö University Hospital, Sweden.
Orthopedics. 1997 Feb;20 Suppl:22-5.
This prospective, double-blind trial was performed to determine whether 4 weeks' prophylaxis with enoxaparin after total hip replacement (THR) is more effective in protecting against deep vein thrombosis (DVT) than prophylaxis during hospitalization. Two hundred sixty-two patients undergoing THR were given enoxaparin 40 mg once daily during hospitalization (9 +/- 2 days) before being randomized at discharge to continue enoxaparin (N = 131) or receive placebo (N = 131) for a total of 1 month (30 +/- 4 days). According to intention-to-treat analysis, 43 DVT and 2 pulmonary emboli (PE) occurred in the placebo group (34.4%) versus 21 DVT and no PE in the enoxaparin group (P < 0.001). The reduction in proximal DVT was also significant (21.4 vs 6.1%; P < 0.001). No major bleeding complications developed. Prophylaxis with enoxaparin for one month significantly reduces venous thromboembolic disease in patients undergoing THR compared to conventional prophylaxis during hospitalization.
这项前瞻性双盲试验旨在确定全髋关节置换术（THR）后使用依诺肝素进行4周预防在预防深静脉血栓形成（DVT）方面是否比住院期间预防更有效。262例接受THR的患者在住院期间（9±2天）每天接受一次40mg依诺肝素治疗，出院时随机分组，继续使用依诺肝素（N = 131）或接受安慰剂（N = 131），共治疗1个月（30±4天）。根据意向性分析，安慰剂组发生43例DVT和2例肺栓塞（PE）（34.4%），而依诺肝素组发生21例DVT且无PE发生（P < 0.001）。近端DVT的减少也很显著（21.4%对6.1%；P < 0.001）。未发生重大出血并发症。与住院期间的传统预防相比，使用依诺肝素预防1个月可显著降低接受THR患者的静脉血栓栓塞性疾病。
