Efficacy and safety of thromboprophylaxis with low molecular weight heparin after lumbar decompressive surgery / 中华骨科杂志

ABSTRACT

Objective To evaluate the efficacy and safety of thromboprophylaxis with low molecular weight heparin after lumbar decompressive surgery.Methods Between January 2004 and April 2011,patients who had undergone lumbar decompressive surgery and had high or very high risk of venous thrombosis were selected.All patients received subcutaneous injection of low molecular weight heparin (Fraxiparine),starting at 6 hours after surgery with a half dose and subsequently once every 24 hours with full dose until discharge.When 24-hour drainage volume was less than 50 ml,the drainage tube was removed 2 hours prior to low molecular weight heparin administration.The occurrences of deep venous thrombosis (DVT),pulmonary embolism (PE),bleeding complications and side effects were recorded.Results Seventy eight patients were enrolled in the study.The average time of drug use was 8.5 days.No symptomatic DVT,PE and major bleeding events occurred.Drainage tube was placed in all patients except 3 patients with lumbar disc herniation.The mean total drainage volume was (319.5±218.5) ml,and the average time from operation to removal of drainage tube was (43.2±14.4) hours.Incision site ecchymosis occurred in 1 patient,incision bleeding in 1 patient,mild elevation in hepatic aminotransferase levels in 4 patients,and mild anaphylaxis in 1 patient.Conclusion It is effective and safe to prevent VTE with low molecular weight heparin for patients with high or very high risk of venous thrombosis after lumbar decompressive surgery.