摘要:

SummaryThe authors have studied the prophylactic effect of subcutaneous heparin in weak doses in preventing postoperative deep-vein thrombosis (D.V.T.) in 144 patients. Heparin was administered 2 hours before the operation and every 8 hours during 6 days thereafter, each time with a dose of 5000 U subcutaneously.50 patients were randomised into two groups of 27 control patients and 23 patients treated with heparin. 94 other patients were investigated in a double-blind trial: 47 operated patients received placebo injections and 47 others heparin.D.V.T. was clinically recognized as well as by the labelled fibrinogen technique.In the control group of 74 operated patients, a D.V.T. was clinically recognized in 7 patients, and by the isotopic test in 37 patients. In the treated group of 70 patients, no D.V.T. was clinically recognized but the labelled fibrinogen test recognized a D.V.T. in 11 patients.The authors observed no hemorrhagic complications which could be attributed to heparin. Low-dose of subcutaneous heparin is efficient and safe in preventing postoperative D.V.T.

ISSN:1784-3286    

DOI:10.1080/17843286.1977.11717897

出版商:Taylor&Francis    

年代:1977

数据来源: Taylor

摘要:

SummaryMiscellaneous pharmacological agents have been claimed to enhance fibrinolysis by liberation of endogenous activators but most of them, especially the vasoactive drugs, have only a transient effect.After administration of phenformin (100 mg/d) plus ethyloestrenol (8 mg/d), the plasminogen activator activity in vein walls (biopsy specimens from superficial hand veins) increased in healthy volunteers, but the fibrinolytic response to venous occlusion did not change.In patients with thrombotic disease, before treatment with this combination, abnormally low plasminogen activator content in the vein walls and/or low fibrinolytic activity on venous occlusions was observed in all cases. After treatment, the plasminogen activator level in the vein wall increased significantly and the release in response to venous occlusion increased to normal levels in most of the patients, indicating both a stimulation of the synthesis and the release of plasminogen activator. It took at least three months treatment to obtain normal level and response.The anabolic steroid ethyloestrenol alone has a similar effect after three months, but the response to venous occlusion was not so striking, and no further increase was found during the treatment.With moroxydine chloride, a phenformin-like substance, the plasminogen activator activity of the vessel wall was normalized in most of the patients, but the increased release capacity was not stable.A combination of an anabolic steroid and a biguanide thus seem to have the best stimulating effect on the endogenous fibrinolysis.

ISSN:1784-3286    

DOI:10.1080/17843286.1977.11717898

出版商:Taylor&Francis    

年代:1977

数据来源: Taylor

摘要:

SummaryRecent deep vein thrombosis of the iliofemoral segment often leads to pulmonary embolism and to impaired valve function. Although more common, occlusions in the calf veins are less dangerous, and often a self-limiting disorder as almost half of these thrombi lyse spontaneously. Approximately 70 % of fresh deep venous thrombi dissolve under intensive and prolonged thrombolytic treatment with streptokinase and long term follow-up study indicate that normal valve function is preserved in those patients in whom thrombus clearance was obtained.Thrombolysis with streptokinase or urokinase appears to be the current treatment of choice for most cases of massive and severe, lifethreatening pulmonary embolism; those patients surviving more than an hour or so after massive infarction comprise a prognostically better group, for whom the chances of surviving embolectomy is actually smaller than the probability of survival without surgery but with thrombolytic treatment.Several large scale trials with streptokinase and one with urokinase in patients with recent myocardial infarction have been performed. In general, trials conducted in coronary care units have shown no significant increase of the survival rate but the mortality in the control group was low, while studies conducted in general wards had a higher mortality in the control group, which in most studies could be significantly reduced by thrombolytic therapy. The results of other trials have been completed but not yet reported; it is hoped that these studies will help in defining the position of thrombolytic therapy in the treatment of myocardial infarction.Acute peripheral arterial thromboembolism was the first clinical situation for which serial angiographic studies established beyond doubt that thrombolytic agents are indeed capable of dissolving spontaneous thrombi and emboli inman. Since then, major progress in vascular surgery (Fogarty balloon catheter) has been made and this approach is now to be preferred, if feasible.In chronic arterial insufficiency, complete arterial occlusions and stenotic lesions have also been removed by thrombolytic treatment. This treatment is probably best reserved for patients with severe symptoms not requiring rapid relief, with a relatively poor operative prognosis and with short occlusions (less than 12 cm), inducing clinical symptoms since less than 12 months.

ISSN:1784-3286    

DOI:10.1080/17843286.1977.11717899

出版商:Taylor&Francis    

年代:1977

数据来源: Taylor

ISSN:1784-3286    

DOI:10.1080/17843286.1977.11717900

出版商:Taylor&Francis    

年代:1977

数据来源: Taylor