Rationale for low-molecular-weight heparin prophylaxis after total knee arthroplasty

被引：12

作者：

Colwell, Clifford W., Jr. ^{[1
]}

Hardwick, Mary E. ^{[1
]}

机构：

[1] Scripps Clin, Shiley Ctr Orthopaed Res & Educ, La Jolla, CA 92037 USA

来源：

CLINICAL ORTHOPAEDICS AND RELATED RESEARCH | 2006年 / 452期

关键词：

D O I：

10.1097/01.blo.0000238826.63648.c5

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

Low-molecular-weight heparin has been studied extensively in total knee arthroplasty (TKA) and provides highly effective and safe prophylaxis against deep venous thrombosis (DVT). Low-molecular-weight heparin received the highest rating (A1) in the American College of Chest Physicians recommendations for DVT prophylaxis after elective TKA. Prevalence of DVT with low-molecular-weight heparin prophylaxis was 33% in TKA data pooled from six randomized studies, with a proximal DVT rate of 7.1%. A metaanalysis reported a 2.4% rate of major bleeding with low-molecular-weight heparin.(2) Low-molecular-weight heparin, given by subcutaneous injection, can be started before surgery or after surgery. A synthetic pentasaccharide (fondaparinux), which received an A1 rating in the American College of Chest Physicians recommendations, also is available. As with all treatments, the benefit must be considered against the risk when using these anticoagulants.

引用

页码：181 / 185

页数：5