Low molecular weight heparin and unfractionated heparin for prevention of thrombo-embolism in general surgery: a meta-analysis of randomised clinical trials.
Low molecular weight heparin and unfractionated heparin for prevention of thrombo-embolism in general surgery: a meta-analysis of randomised clinical trials.
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低分子量肝素和普通肝素在普通外科中预防血栓栓塞：随机临床试验的荟萃分析。
DOI：
10.1159/000217436
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发表时间：
1997
期刊：
影响因子：
--
通讯作者：
R. Bergemann
中科院分区：
文献类型：
--
作者：
A. Palmer;W. Schramm;B. Kirchhof;R. Bergemann
比较低分子肝素（LMWH）、普通肝素（UFH）和华法林在普外科预防血栓栓塞的有效性和安全性。采用荟萃分析 (MA) 和 MA 方案的先验定义，将随机试验的结果与接受普通手术和使用 LMWH、UFH 或华法林预防深静脉血栓 (DVT) 的患者进行结合。确定了 44 项研究进行评估，其中包括 33 项，但没有一项是针对华法林的。对于疗效（DVT 和肺栓塞）和大出血，LMWH 和 UFH 治疗组之间没有显着差异。 LMWH 与 UFH 相比，轻微出血的相对风险为 0.75（0.64-0.88；95% 置信区间），且显着（p < 0.05）。在 MA 的限制内，LMWH 和 UFH 在预防血栓栓塞方面没有显着差异，但 LMWH 的安全性明显更好。在此基础上，LMWH 在预防普外科血栓栓塞方面可能优于 UFH。
Low molecular weight heparin (LMWH), unfractionated heparin (UFH) and warfarin were compared with respect to efficacy and safety in the prevention of thrombo-embolism in general surgery. Meta-analysis (MA) with a priori definition of the MA protocol was used to combine the results from randomised trials with patients who underwent general surgery and deep-vein thrombosis (DVT) prophylaxis with LMWH, UFH or warfarin. Forty-four studies were identified for assessment and 33 were included, however, none for warfarin. For efficacy (DVT and pulmonary embolism) and major bleeding, no significant difference between the LMWH- and UFH-treated groups was demonstrated. The relative risk of minor bleedings for LMWH versus UFH was 0.75 (0.64-0.88; 95% confidence interval) and is significant (p < 0.05). Within the limitations of the MA, LMWH and UFH did not differ significantly in terms of prevention of thrombo-embolism, but LMWH had a significantly better safety profile. On this basis, LMWH may be preferable to UFH in the prevention of thrombo-embolism in general surgery.