Comparison of Various Types of Pharmacological
Prevention of Lower Extremities Deep Vein Thrombosis in Patients with Proximal Femoral Fractures
Trča S., Krška Z., Sedlář M., Kudrnová Z.*, Dohnalová A.**
I. chirurgická klinika VFN a 1. LF UK v Praze, přednosta: doc. MUDr. J. Šváb, CSc. *Centrální hematologické laboratoře a trombotické centrum VFN, Praha *Kybernetické oddělení Fyziologického ústavu 1. LF UK, Praha |
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Summary:
Adminstration of coagulation-active substances is one of the options to prevent thromboemboembolic disease (TED), including deep
vein thrombosis and systemic response to stress entailed by an injury or a surgical procedure. Lately, a synthetic analogue of the heparin
molecule – of its functionally active part – pentasaccharide (PS), has been developed, among others.
Potential effects of different pharmacopreventive therapies of the deep vein thrombosis was studied in a group of 146 subjects, who
suffered proximal femoral fractures and were operated in the Ist Surgical Clinic,VFN Hospital, during 2001–2006. The patients were randomized
into 4 different anticoagulant groups (UFH, LMWH, PS short-term and PS long-term). Thromboembolic symptoms, selected
postoperative complications and laboratory findings of selected blood count parameters, coagulation, active phase proteins and adhesion
molecules, were monitored.
The results indicate existing increased risk of the deep vein thrombosis and a lower rate of the coagulation and fibrinolytic cascade
activation, suggesting a higher rate of the hemostatic status stability in the pentasaccharide groups, especially in the groups receiving the
long-term pentasaccharide medication (over a month). Therefore, potential pentasaccharide protective effect preventing development of
the deep vein thrombosis may be expected.
Key words:
injury – venous thrombosis – pentasaccharide – prevention
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