RESUMEN
The article represents the results of the Study "The safety territory of venous thromboembolic complications". 59 surgical hospitals took part in the multi-centered study. The risk assessment of the venous thromboembolic complications and prevention measured were analyzed in 53, 596 patients.
Asunto(s)
Ambulación Precoz/métodos , Fibrinolíticos/uso terapéutico , Aparatos de Compresión Neumática Intermitente , Complicaciones Posoperatorias , Procedimientos Quirúrgicos Operativos/efectos adversos , Tromboembolia Venosa , Adulto , Femenino , Humanos , Masculino , Cuidados Posoperatorios/métodos , Cuidados Posoperatorios/estadística & datos numéricos , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/prevención & control , Medición de Riesgo , Factores de Riesgo , Federación de Rusia/epidemiología , Prevención Secundaria/métodos , Prevención Secundaria/estadística & datos numéricos , Medias de Compresión , Procedimientos Quirúrgicos Operativos/estadística & datos numéricos , Análisis de Supervivencia , Resultado del Tratamiento , Tromboembolia Venosa/epidemiología , Tromboembolia Venosa/etiología , Tromboembolia Venosa/prevención & controlRESUMEN
AIM: To compare efficacy and safety of warfarin and enoxaparin used in the first month of treatment of patients with an episode of deep vein thrombosis (DVT) and/or pulmonary artery thromboembolism (PATE). MATERIAL AND METHODS: Sixty patients (34 males, 26 females, age 18-76 years) after the DVT/PATE episode were divided into two groups. Patients of group 1 received standard therapy (non-fractionated heparin -NFH followed by warfarin), patients of group 2 instead of NFH received enoxaparin (1 mg/kg each 12 hours for at least 30 days). Ultrasonic scanning of the limbs and determination of D-dimer were conducted before and after 1 month of treatment. End points were the following: recurrent DVT/PATE, death due to PATE, hemorrhagic complications. RESULTS: Improvement of deep vein patency after 1 month of anticoagulant treatment was observed in both the groups. Enoxaparin proved more effective in relation to reduction of the number of venous occlusions (9 and 50, respectively, after 1 month treatment (p < 0.001). Hemorrhagic complications were seen in both the groups with equal frequency (13.4%). These hemorrhagic episodes did not require discontinuation of the drugs. Baseline D-dimer was significantly higher in the enoxaparin group--1.51 (0.73-2.44) mcg/ml vs 0.93 (0.42-1.33) mcg/ml (p = 0.019). After treatment D-dimer level and number of patients with high D-dimer diminished in both groups. CONCLUSION: Enoxaparin proved more effective than warfarin in the first treatment month. In the same safety and prophylactic effect enoxaparin is more effective in recanalization of occusions in the deep veins.