Comparison of Various Types of Pharmacological Prevention of Lower Extremities Deep Vein Thrombosis in Patients with Proximal Femoral Fractures


Authors: S. Trča;  Z. Krška;  M. Sedlář;  Z. Kudrnová *;  A. Dohnalová **
Authors‘ workplace: I. chirurgická klinika VFN a 1. LF UK v Praze, přednosta: doc. MUDr. J. Šváb, CSc. ;  Centrální hematologické laboratoře a trombotické centrum VFN, Praha *;  Kybernetické oddělení Fyziologického ústavu 1. LF UK, Praha *
Published in: Rozhl. Chir., 2007, roč. 86, č. 5, s. 241-248.
Category: Monothematic special - Original

Overview

Adminstration of coagulation-active substances is one of the options to prevent thromboemboembolic disease (TED), including deep vein thrombosis and systemic response to stress entailed by an injury or a surgical procedure. Lately, a synthetic analogue of the heparin molecule – of its functionally active part – pentasaccharide (PS), has been developed, among others.

Potential effects of different pharmacopreventive therapies of the deep vein thrombosis was studied in a group of 146 subjects, who suffered proximal femoral fractures and were operated in the Ist Surgical Clinic, VFN Hospital, during 2001–2006. The patients were randomized into 4 different anticoagulant groups (UFH, LMWH, PS short-term and PS long-term). Thromboembolic symptoms, selected postoperative complications and laboratory findings of selected blood count parameters, coagulation, active phase proteins and adhesion molecules, were monitored.

The results indicate existing increased risk of the deep vein thrombosis and a lower rate of the coagulation and fibrinolytic cascade activation, suggesting a higher rate of the hemostatic status stability in the pentasaccharide groups, especially in the groups receiving the long-term pentasaccharide medication (over a month). Therefore, potential pentasaccharide protective effect preventing development of the deep vein thrombosis may be expected.

Key words:
injury – venous thrombosis – pentasaccharide – prevention


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Surgery Orthopaedics Trauma surgery
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