Therapeutic Use of Low-Molecular-Weight Heparins
作者:
Russell D. Hull,
Graham F. Pineo,
期刊:
Pathophysiology of Haemostasis and Thrombosis
(Karger Available online 1993)
卷期:
Volume 23,
issue 1
页码: 2-9
ISSN:1424-8832
年代: 1993
DOI:10.1159/000216901
出版商: S. Karger AG
关键词: Heparin;low molecular weight;Heparin;standard;Warfarin;Venous thromboembolism;Deep venous thrombosis;Pulmonary embolism
数据来源: Karger
摘要:
Accumulating evidence indicates that certain low-molecular-weight (LMW) heparins administered subcutaneously may replace classic intravenous heparin therapy. LMW heparins do not require monitoring and may be safer and more effective than unfractionated heparin. The decreased mortality rate, evident in two randomized trials, which was particularly striking in patients with metastatic carcinoma, requires confirmation. The simplified care offered by LMW heparin therapy raises the possibility of transferring care from in-hospital to out of hospital in uncomplicated patients with deep-vein thrombosis [Salzman EW: Low-molecular weight heparin and other new antithrombotic drugs. N Engl J Med 1992;326: 1017-1019]. The advantages to the patient of avoiding in-hospital care and its associated hazards are obvious. Outpatient LMW heparin therapy will likely prove to be highly cost-effective. It is uncertain at present whether the findings associated with an individual LMW heparin preparation can be extrapolated to a different LMW heparin. For this reason the findings of clinical trials apply only to the particular LMW heparin evaluated and cannot be generalized to the LMW heparins at large.
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