Palmer A J, Koppenhagen K, Kirchhof B, Weber U, Bergemann R
Institute for Medical Informatics and Biostatistics, Riehen, Switzerland.
Haemostasis. 1997 Mar-Apr;27(2):75-84. doi: 10.1159/000217437.
The efficacy and safety of low molecular weight heparin (LMWH), unfractionated heparin (UFH) and warfarin for prophylaxis of thrombo-embolism in orthopaedic surgery were compared using meta-analysis techniques. Twenty-two studies were included, 2 of which compared LMWH to warfarin. The mean probabilities to develop deep-vein thrombosis (DVT), pulmonary embolism and major and minor bleeding using UFH were: 0.21 (95% confidence interval, CI: 0.18-0.24); 0.01 (95% CI: 0.01-0.02); 0.05 (95% CI: 0.03-0.07), and 0.19 (95% CI: 0.17-0.22), respectively. The relative risk (RR) of DVT for LMWH vs. UFH was 0.76 (95% CI: 0.60-0.91), p < 0.05 and for LMWH vs. warfarin 0.78 (95% CI: 0.69-0.87), p < 0.05. The RR of minor bleeding for LMWH vs. UFH was 0.76 (95% CI: 0.64-0.92), p < 0.05. The RR of minor bleeding for LMWH vs. warfarin was 3.28 (95% CI: 2.21-4.70), p < 0.05.
in orthopaedic surgery, LMWH is significantly superior to both UFH and warfarin in the prevention of DVT and results in significantly less minor bleeding complications when compared to UFH, but significantly more minor bleeding when compared to warfarin.
采用荟萃分析技术比较了低分子肝素（LMWH）、普通肝素（UFH）和华法林在骨科手术中预防血栓栓塞的疗效和安全性。纳入了22项研究，其中2项将LMWH与华法林进行了比较。使用UFH发生深静脉血栓形成（DVT）、肺栓塞以及严重和轻微出血的平均概率分别为：0.21（95%置信区间，CI：0.18 - 0.24）；0.01（95%CI：0.01 - 0.02）；0.05（95%CI：0.03 - 0.07），以及0.19（95%CI：0.17 - 0.22）。LMWH与UFH相比，DVT的相对风险（RR）为0.76（95%CI：0.60 - 0.91），p < 0.05；LMWH与华法林相比，RR为0.78（95%CI：0.69 - 0.87），p < 0.05。LMWH与UFH相比，轻微出血的RR为0.76（95%CI：0.64 - 0.92），p < 0.05。LMWH与华法林相比，轻微出血的RR为3.28（95%CI：2.21 - 4.70），p < 0.05。
在骨科手术中，LMWH在预防DVT方面显著优于UFH和华法林，与UFH相比，轻微出血并发症显著减少，但与华法林相比，轻微出血显著增多。
