ABSTRACT
UNLABELLED: Our paper represents a synopsis of the main mechanisms by which low-molecular-weight heparins act as pharmacodynamic stabilizing factors of the liquid coagulation balance, in the postoperative period. Today we note three main phases in the coagulation mechanism: 1. partial thrombin activation; 2. positive thrombin-mediated feedback; 3. explosive thrombin formation. Low-molecular-weight heparins (Clivarine-mean molecular weight = 3900 D) act as selective inhibitors an factor X a (anti-thrombotic action), and as weak inhibitors on factor II a. The authors' experience includes 321 patients, who received Clivarin as preventive therapy for thromboembolic disease. Most of the selected patients are included in groups 2 and 3 for thromboembolic risk--and have undergone general surgery and oncological surgery. The dosage and duration of the treatment have been the usual ones. The main clinical observations we noted are: 1. excellent tolerability of Clivarine; 2. no modifications of usual biological values; 3. no adverse reactions were noted. There were no deleterious interferences between Clivarine and the usual postoperative medication of the surgical patient, 4. among the incidents, we note 12 postinjection haematomas, which were spontaneously cured. CONCLUSIONS: Low-molecular-weight heparins are considered today drugs of election in the medical and surgical thrombosis prophylaxis.
