低分子肝素预防髋膝关节术后下肢深静脉血栓形成

目的 评价低分子肝素预防髋、膝关节术后深静脉血栓形成（DVT）的疗效和安全性。方法 1997年4月－1998年10月选择接受髋、膝周围手术的患者46例均为40岁以上，3个月内无血栓栓塞性疾病史、无凝血功能障碍，术前经彩色多普勒超声法筛查，双下肢无DVT，随机分成两组。预防组应用低分子肝素（速避凝）预防DVT，对照组不采用任何预防措施。术后第4－7天行患侧静脉造影，了解深静脉血栓的发生情况。结果 对照组中8例发生DVT，占34．8％；预防组中1例发生DVT，占4．3％。经统计学处理有显著性差异（P＜0．05）。两组均未发生明显的出血并发症。结论 低分子肝素能安全、有效地预防髋膝关节术后深静脉血栓形成。

PROPHYLAXIS FOR DEEP VEINTHROMBOSIS WITH LOW MOLECULAR WEIGHT HEPARIN FOLLOWING HIP AND KNEE SURGERY

OBJECTIVE: To evaluate the efficacy and safety of low molecular weight heparin(LMWH) in prophylaxis of postoperative deep vein thrombosis (DVT) following hip and knee surgery. METHODS: From April 1997 to October 1998, 46 patients undergoing hip and knee orthopedic procedures were randomized into 2 groups for studying. The following eligibility criteria were applied: age over 40 years old, no recently history of venous thromboembolism (over 3 months), normal result of preoperative hemostasis test and normal result of Doppler examination of the lower extremities. One group was control group and the other group received subcutaneously a low molecular weight heparin(Fraxiparine) with anti-factor X, activity of 41 IU/kg.day for three days, then 62 IU/kg.day from the 4th day to 10th day. All patients had venegraphy performed in the operated leg at 4 to 7 days after surgery. RESULTS: eight patients(34.8%) developed DVT in the control group of 23 patients and 1 patient (4.3%) in the experimental group, also of 23 patients(P < 0.05). Two groups had no any bleeding complications. CONCLUSION: The low molecular weight heparin is safe and effective in preventing postoperative deep vein thrombosis in patients following hip and knee surgery.