Prevention of deep-vein thrombosis and pulmonary embolism after total hip replacement. Comparison of low-molecular-weight heparin and unfractionated heparin.

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Eriksson, Bengt I.,1946Gothenburg University,Göteborgs universitet,Institutionen för de kirurgiska disciplinerna, Avdelningen för ortopedi,Institute of Surgical Sciences, Department of Orthopaedics (författare)

Prevention of deep-vein thrombosis and pulmonary embolism after total hip replacement. Comparison of low-molecular-weight heparin and unfractionated heparin.

Artikel/kapitelEngelska1991

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1991

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LIBRIS-ID:oai:gup.ub.gu.se/197856
https://gup.ub.gu.se/publication/197856URI

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Språk:engelska

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In a prospective, randomized, double-blind study, the efficacy and safety of a low-molecular-weight heparin were compared with those of unfractionated sodium heparin (standard heparin) in 136 patients who had elective total hip replacement. The patients received subcutaneous injection of either 5000 international units of low-molecular-weight heparin once daily or 5000 international units of standard heparin three times a day. Treatment with low-molecular-weight heparin began twelve hours before the operation, and treatment with standard heparin began two hours preoperatively; both regimens were continued for ten days. Twelve days postoperatively, bilateral ascending phlebography was performed in 122 patients, sixty-three in the treatment group that received low-molecular-weight heparin and fifty-nine in the treatment group that received standard heparin. Pulmonary scintigraphy was performed in 127 patients. Deep-vein thrombosis was diagnosed in forty-four patients: nineteen (30 per cent) of the sixty-three who received low-molecular-weight heparin and twenty-five (42 per cent) of the fifty-nine who received standard heparin. All but four patients, two from each treatment group, were asymptomatic. The difference in the total rate of thrombosis in the two groups was not significant (p = 0.189). However, thrombosis occurred in the thigh in only six (10 per cent) of the patients who received low-molecular-weight heparin but in eighteen (31 per cent) of those who received standard heparin, a significant difference (p = 0.011). Pulmonary embolism was detected in twenty-seven patients: eight (12.3 per cent) of those who received low-molecular-weight heparin and nineteen (30.6 per cent) of those who received standard heparin. Only three patients had clinical signs of embolism. Pulmonary embolism was significantly more frequent in the group that received standard heparin (p = 0.016). Total loss of blood and the total amount of blood that was transfused were significantly reduced in the patients who received low-molecular-weight heparin compared with those who received standard heparin. Prophylaxis was not discontinued because of hemorrhage in any patient. The efficacy of low-molecular-weight heparin was superior to that of standard heparin in the prevention of femoral thrombosis and pulmonary embolism, although the over-all incidence of deep-vein thrombosis was not statistically different.(ABSTRACT TRUNCATED AT 400 WORDS)

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine hsv//eng
Aged
Antibodies
metabolism
Blood Loss
Surgical
statistics & numerical data
Chemical Fractionation
Double-Blind Method
Factor Xa
immunology
Female
Heparin
adverse effects
therapeutic use
Hip Prosthesis
adverse effects
Humans
Male
Middle Aged
Molecular Weight
Phlebography
Prospective Studies
Pulmonary Embolism
etiology
prevention & control
radionuclide imaging
Risk Factors
Thrombophlebitis
etiology
prevention & control
radiography

Biuppslag (personer, institutioner, konferenser, titlar ...)

Kälebo, Peter (författare)
Anthymyr, B A (författare)
Wadenvik, Hans,1955Gothenburg University,Göteborgs universitet,Institutionen för invärtesmedicin, Avdelningen för internmedicin,Institute of Internal Medicine, Dept of Medicine(Swepub:gu)xwadha (författare)
Tengborn, L (författare)
Risberg, Bo,1941Gothenburg University,Göteborgs universitet,Institutionen för de kirurgiska disciplinerna, Avdelningen för kirurgi,Institute of Surgical Sciences, Department of Surgery(Swepub:gu)xrisbb (författare)
Göteborgs universitetInstitutionen för de kirurgiska disciplinerna, Avdelningen för ortopedi (creator_code:org_t)

Sammanhörande titlar

Ingår i:The Journal of bone and joint surgery. American volume73:4, s. 484-930021-9355

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Av författaren/redakt...: Eriksson, Bengt ...; Kälebo, Peter; Anthymyr, B A; Wadenvik, Hans, ...; Tengborn, L; Risberg, Bo, 194 ...

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Av lärosätet: Göteborgs universitet

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