Sharnoff J G, Rosen R L, Sadler A H, Ibarra-Isunza G C
J Bone Joint Surg Am. 1976 Oct;58(7):913-8.
From 1960 through 1975, 337 patients with surgically treated acute fracture of the hip received subcutaneously administered heparin to prevent thromboembolic disease according to various regimens. Four hundred and three patients received no heparin. The incidence of fatal pulmonary embolism was 3.5 per cent in the 403 patients who reveived no heparin and 0.0 per cent in the 147 patients who were treated by the currently used regimen of prophylaxis, as follows: With the dose modified according to the coagulometer-test time, patients received 2,500 units on admission and every six hours until the day before operation. Then they were given 5,000 to 10,000 units eight to ten hours before surgery and 2,500 units every six hours after surgery until they were fully mobilized.
从1960年到1975年,337例接受手术治疗的髋部急性骨折患者根据不同方案皮下注射肝素以预防血栓栓塞性疾病。403例患者未接受肝素治疗。在未接受肝素治疗的403例患者中,致命性肺栓塞的发生率为3.5%,而在采用目前预防性治疗方案治疗的147例患者中,发生率为0.0%,具体方案如下:根据凝血计检测时间调整剂量,患者入院时接受2500单位,每6小时一次,直至手术前一天。然后在手术前8至10小时给予5000至10000单位,术后每6小时给予2500单位,直至患者完全活动自如。