WARFARIN SODIUM VERSUS LOW-DOSE HEPARIN IN THE LONG-TERM TREATMENT OF VENOUS THROMBOSIS
WARFARIN SODIUM VERSUS LOW-DOSE HEPARIN IN THE LONG-TERM TREATMENT OF VENOUS THROMBOSIS
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DOI：
10.1056/nejm197910183011602
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发表时间：
1979-01-01
影响因子：
158.5
通讯作者：
ARMSTRONG, P
中科院分区：
文献类型：
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作者：
HULL, R;DELMORE, T;ARMSTRONG, P
急性深静脉血栓形成通常用静脉注射肝素治疗数天，然后用口服抗凝剂治疗数周至数月。调整剂量华法林钠与固定低剂量s.c.肝素预防复发性深静脉血栓形成。静脉造影证实的急性深静脉血栓形成患者（68例）接受静脉注射肝素治疗，然后随机接受二级预防。在35例患者中，9例接受s.c.肝素，但没有33个接受华法林钠有客观记录的静脉血栓栓塞新的事件（P = 0.001）。在服用华法林钠的患者中，7例发生出血并发症（其中4例为严重出血），而接受皮下注射的患者中无一例发生出血并发症。肝素（P < 0.005）。调整剂量华法林钠比小剂量s.c.更有效。肝素在预防复发性静脉血栓栓塞中的作用，但其使用伴随着出血的重大风险。
Acute deep-vein thrombosis is usually treated with i.v. heparin for a number of days, then with oral anticoagulants for weeks-months. Adjusted-dose warfarin sodium was compared with fixed low-dose s.c. heparin in the prevention of recurrent deep-vein thrombosis. Patients (68) with acute deep-vein thrombosis confirmed by venography were treated with i.v. heparin and then randomized to secondary prophylaxis. Of 35 patients, 9 receiving s.c. heparin, but none of 33 receiving warfarin sodium had new episodes of objectively documented venous thromboembolism (P = 0.001). Of patients on warfarin sodium, 7 experienced bleeding complications (of which 4 were major), as compared with no patients receiving s.c. heparin (P < 0.005). Adjusted-dose warfarin sodium is more effective than low-dose s.c. heparin in preventing recurrent venous thromboembolism, but its use is accompanied by a significant risk of bleeding.