Efficacy and safety of early low-molecular-weight heparin sodium in prevention of posttraumatic venous thromboembolism / 中华创伤杂志

ABSTRACT

Objective To evaluate the efficacy and safety of early anticoagulation therapy using low-molecular-weight heparin sodium against venous thromboembolism (VTE) in traumatic patients.Methods A total of 120 severely traumatized patients were assigned to convention group (n =60) and anticoagulation group (n =60) according to the random number table.Patients in convention group were given physical therapy against VTE,while in anticoagulation group were given add-on low-molecularweight heparin sodium against VTE once the stopping of blood bleeding was achieved.Safety parameters were recorded including VTE incidence,blood loss indexes,hemorrhage-related complications,incidence of heparin-induced thrombopenia (HIT) and blood coagulation function indicators.Results Thirteen patients presented with VTE,with 10 patients (17％) in convention group versus 3 patients 5％) in anticoagulation group (P ＜ 0.05).Blood loss index in convention group was 1.252 ± 1.033 versus 1.447 ± 1.196 in anticoagulation group;two patients (3％) developed gastrointestinal bleeding in convention group versus five patients (8％) in anticoagulation group;five patients (8％) had wound bleeding in convention group versus eight patients (13％) in anticoagulation group (all P ＞ 0.05).HIT was not noted in anticoagulation group.At the endpoint of evaluation,no significant differences were noted between the two groups with regard to changes in prothrombin time (PT),activated partial thromboplastin time (APTT) and D-dimers (P ＞ 0.05);however,convention group versus anticoagulation group showed significant differences in international normalized ratio (INR) (0.97 ± 0.10 vs.1.03 ±0.17),fibrin (Fib) [(4.85-± 1.37) g/L vs.(4.01 ± 1.16) g/L] and platelet (PLT) [(317.68 ±141.71) ×109/Lvs.(422.20±178.16) ×109/L] (P＜0.05).Conclusion Inthe earlystage of trauma,low-molecular-weight heparin anticoagulation therapy can significantly reduce the incidence of VTE without increasing the risk of bleeding.