[Evaluation of undesirable effects of low-molecular-weight heparin during prevention of thromboembolic disease in abdominal surgery patients].
The objective of the present study was to determine the type, frequency and severity of the side effects of a low-molecular-weight heparin (LMWH) during the prophylaxis of thromboembolic disease (TED) after abdominal surgery. The study was prospective, comparative, longitudinal, and open. The setting was at the surgical and hematology services of a teaching hospital. There were 57 patients (27 males, 30 females) with risk factors for TED, including gastrointestinal malignancies. Seventeen patients (Group A) received LMWH, 20 mg/day; 20 (Group B) standard heparin (SH), 5,000 U/12 h, and 20 (Group C) formed the control group. LMWH or SH were administered 2 h before surgery and then, when patients assumed complete ambulatory status, at the end of their hospital stay or for a maximum of ten days. There were no significant differences among the groups in relation with age, anthropometric variables, type and duration of surgery, nor in the extent of the surgical bleeding, days to full ambulatory status nor length of postoperative hospital stay. A similar number of erythrocyte transfusions were used on the three groups. Eighty-three percent of the patients were 50 years of age or older. None developed TED. Postoperatively in group "A" a significant increase in platelets (p = 0.01) was found, as was the shortening of the activated partial thromboplastin time (P = 0.007); other adverse effects did not occur during the administration of LMWH. These findings allowed us to conclude that LMWH constitutes a safe, reliable and comfortable alternative for prophylaxis of TED in this type of surgical patients.
Morales-Polanco
M R
MR
Servicio de Hematología, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, IMSS, México, D. F.
Sigler-Morales
L
L
Meillón-García
L A
LA
Romero-Hernández
T
T
Blanco-Benavides
R
R
D000005:Abdomen / Q000601:surgery*; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects*; D001803:Blood Transfusion; D003627:Data Interpretation, Statistical; D017984:Enoxaparin / Q000008:administration & dosage / Q000627:therapeutic use; D005069:Evaluation Studies as Topic; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007902:Length of Stay; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013923:Thromboembolism / Q000517:prevention & control*
D000925:Anticoagulants; D017984:Enoxaparin; D006495:Heparin, Low-Molecular-Weight
Valoración de los efectos indeseables de una heparina de bajo peso molecular, durante la profilaxia de enfermedad tromboembólica en pacientes de cirugía abdominal.