Zusammenfassung
Thromboembolische Ereignisse stellen eine schwerwiegende Komplikation in der chirurgischen und inneren Medizin dar. Die tödliche Lungenembolie entsteht bei etwa 3% der Patienten nach Hüftgelenkersatz, bei 0,1–6% der Patienten in der Abdominalchirurgie bis hin zu 8% bei ausgedehnten Amputationen der unteren Extremität und bei 1–5% der Patienten mit internistischen Erkrankungen.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Similar content being viewed by others
Literatur
Abernethy EE, Hartsuck J (1974) Postoperative pulmonary embolism: A prospective study utilizing low-dose heparin. Am J Surg 128:739–742
Antiplatelet Trialists’ Collaboration Group (1994) Collaborative overview of randomized trials of antiplatelet therapy III: Reduction of venous thrombosis and pulmonary embolism by antiplatelet prophylaxis among surgical and medical patients. Br Med J 308:235–246
Ballard RM, Bradley-Watson PJ, Johnstone FD et al. (1973) Low doses of subcutaneous heparin in the prevention of deep vein thrombosis after gynecological surgery. J Obstet Gynecol Br Commonw 80:469–475
Bergmann JF, Neuhardt E (1996) A multicenter randomized double-blind study of Enoxaparin compared with unfrac-tionated heparin in the prevention of venous thromboembolic disease in elderly in-patients bedridden for an acute medical illness. Thromb Haemost 76:529–534
Bergqvist D (1997) New approaches to prevention of deep-vein thrombosis. Thromb Haemost 78:684–688
Bergqvist D, Burmark US, Frisell J et al. (1986) Low molecular weight heparin once daily compared with conventional low dose heparin twice daily: A prospective double-blind multicentre trial on prevention of postoperative thrombosis. Br J Surg 73:204–208
Bergqvist D, Mätzsch T, Burmark US et al. (1988) Low molecular weight heparin given the evening before surgery compared with conventional low dose heparin in prevention of thrombosis. Br J Surg 75:888–891
Bergqvist D, Kettunen K, Fredin H et al. (1991) Thromboprophylaxis in hip fracture patients — A prospective randomized comparative study between ORG 10172 and dextran. Surgery 109:617–624
Bergqvist D, Benoni G, Bjorgell O et al. (1996) Low molecular weight heparin (Enoxaparin) as prophylaxis against venous thromboembolism after total hip replacement. N Engl J Med 335:696–700
Borgstrom S, Greitz T, Vander Linden W et al. (1965) Anticoagulant prophylaxis of venous thrombosis in patients with fractured neck of the femur: A controlled clinical trial using venous phlebography. Acta Chir Scand 129:500–508
Caen JO (1988) A randomized double-blind study between a low molecular weight heparin Kabi 2165 and standard heparin in the prevention of deep vein thrombosis in general surgery. Thromb Haemost 59:216–220
Clagett GP, Anderson FA, Heit J et al. (1995) Prevention of venous thromboembolism. Chest 108(Suppl):313S–334S
Cook DJ, Guyatt GH, Laupacis A et al. (1995) Clinical recommendations using levels of evidence for antithrombotic agents. Chest 108:227S–230S
Covey TH, Sherman L, Baue E (1975) Low dose heparin in postoperative patients. Arch Surg 110:1021–1028
Czechanowski B, Heinrich F (1981) Prophylaxe venöser Thrombosen bei frischem ischämischen zerebrovaskulä-ren Insult. Doppelblindstudie mit Heparin-Dihydergot. Dtsch Med Wochenschr 106:1254–1260
Dahan R, Houlbert D, Caulin C et al. (1986) Prevention of deep vein thrombosis in elderly medical patients by a low molecular weight heparin: A randomized double-blind trial. Haemostasis 16:159–168
Dahl OE, Andreassen G, Aspelin T et al. (1997) Prolonged thromboprophylaxis after hip replacement surgery — results of a double-blind prospective, randomized, placebo-controlled study with Dalteparin (Fragmin). Thromb Haemost 77:26–31
Danish Enoxaparin Study Group (1991) Low-molecular-weight heparin (Enoxaparin) vs dextran 70. The prevention of postoperative deep vein thrombosis after total hip replacement. Arch Intern Med 151:1621–1626
Dechavanne M, Saudin F, Viala JJ et al. (1974) Prevention des thromboses veineuses: Succes de l’ heparine a fortes doses lors des Coxarthrose. Nouv Presse Med 3:1317–1319
Dechavanne M, Ville D, Berruyer M et al. (1989) Randomized trial of a low-molecular-weight heparin (Kabi 2165) versus adjusted dose subcutaneous standard heparin in the prophylaxis of deep-vein thrombosis after elective hip surgery. Haemostasis 19:5–12
Emerson PA, Marks P (1977) Preventing thromboembolism after myocardial infarction: effect of low-dose heparin on smoking. Brit Med J 1:18–20
Encke A, Breddin KH (1988) Comparison of a low molecular weight heparin and unfractionated heparin for the prevention of deep vein thrombosis in patients undergoing abdominal surgery. Br J Surg 75:1058–1063
Eriksson BI, Kalebo P, Anthmyr BA et al. (1991) Prevention of deep vein thrombosis and pulmonary embolism after total hip replacement. J Bone Joint Surg 73A:484–493
Eriksson BI, Ekman S, Kalebo P et al. (1996) Prevention of deep vein thrombin after total hip replacement: direct thrombosis inhibition with recombinant hirudin, CGP 39393. Lancet 347:635–639
Eriksson BI, Wille-Jorgensen P, Kalebo P et al. (1997) A comparison of recombinant hirudin with a low-molecular-weight heparin to prevent thromboembolic complications after total hip replacement. N Engl J Med 337:1329–1335
Eskeland G, Solheim K, Skorten F (1966) Anticoagulant prophylaxis, thromboembolism and mortality in elderly patients with hip fractures: A controlled clinical trial. Acta Chir Scand 131:16–24
Estoppey D, Hochreiter J, Breyer HG et al. (1989) ORG 10172 (Lomoparin) versus heparin-DHE in prevention of thromboembolism in total hip replacement — A multicentre trial. Thromb Haemost 62:356–362
Francis CW, Meyer D, Roberts E et al. (1983) Two-step warfarin therapy: Prevention of postoperative venous thrombosis without excessive bleeding. JAMA 249:374–378
Freeark KA, Boswick J, Fardin R (1967) Posttraumatic venous thrombosis. Arch Surg 95:567–575
Fricker JP, Vergnes Y, Schach R et al. (1988) Low dose heparin versus low molecular weight heparin Kabi 2165 in the prophylaxis of thromboembolic complications of abdominal oncological surgery. Eur J Clin Invest 18:561–572
Gallus AS, Hirsh J, Tuttle RJ et al. (1973) Small subcutaneous doses of heparin in prevention of venous thrombosis. N Engl J Med 288:545–551
Gallus AS, Hirsh J, O’ Brien SE et al. (1975) Prevention of venous thrombosis with small subcutaneous doses of heparin. JAMA 235:980–989
Geerts WH, Code KJ, Jay RM et al. (1994) A prospective study of venous thromboembolism after major trauma. N Engl J Med 331:1601–1606
Geerts WH, Jay RM, Code KJ et al. (1996) A comparison of low-dose heparin with low-molecular-weight heparin as prophylaxis against venous thromboembolism after major trauma. N Engl J Med 335:701–717
GHAT Group (1992) Prevention of deep vein thrombosis with low molecular-weight heparin in patients undergoing total hip replacement. A randomized trial. Arch Orthop Trauma Surg 111:110–120
Gibbert FB, Gould SR, Marks P (1976) Incidence of deep vein thrombosis and leg oedema in patients with stroke. J Neurol Neurosurg Psychiatr 39:1222–1225
Gordon-Smith IC, Le Queste LP, Grundy DJ, Newcombe JF (1972) Controlled trial of two regimens of subcutaneous heparin in prevention of postoperative deep-vein thrombosis. Lancet 1:1133–1135
Green D, Lee MY, Lim AC et al. (1990) Prevention of thromboembolism after spinal cord injury using low molecular weight heparin. Ann Intern Med 113:571–574
Groote Schuur Hospital Thromboembolus Study Group (1979) Failure of low-dose heparin to prevent significant thromboembolic complications in high-risk surgical patients: interim report of prospective trial. Br Med J 1:1447–1450
Gruber UF, Duckert F, Fridrich R et al. (1977) Prevention of postoperative thromboembolism by dextran 40, low doses of heparin, or xantional nicotinate. Lancet 1:207–214
Haas S (1996) Risikoabschätzung thromboembolischer Komplikationen bei chirurgischen Erkrankungen und Verletzungen. Akt Chir 31:269–274
Hamilton HW, Crawford JS, Gardiner JH, Wiley AM (1970) Venous thrombosis in patients with fracture of the upper end of the femur. J Bone Joint Surg 52B:268–274
Hampson WGJ, Harris PC, Lucas HK et al. (1974) Failure of low-dose heparin to prevent deep-vein thrombosis after hip replacement arthroplasty. Lancet 11:795–789
Handley AJ (1972) Low dose heparin after myocardial infarction. Lancet 11:623–624
Harenberg J, Schmitz-Huebner U (1997) Therapie der Beinvenenthrombose mit niedermolekularen Heparinen. Dt Ä rztebl 94:A-2257, B-1837, C-1703
Harenberg J, Kallenbach B, Martin U et al. (1990) Randomized controlled study of heparin and low molecular weight heparin for prevention of deep-vein thrombosis in medical patients. Thromb Res 59:639–650
Harenberg J, Roebruck P, Heene DL (1996) Subcutaneous low-molecular-weight heparin versus standard heparin for prevention of thromboembolism in medical in-patients. Haemostasis 26:127–139
Hartle P, Brucke P, Dienstl E, Vinazzer H (1990) Prophylaxis of thromboembolism in general surgery: Comparison between standard heparin and Fragmin. Thromb Res 57:577–584
Heit J, Kessler C, Mammen E et al. for the RD Heparin Study Group (1991) Efficacy of RD heparin (a LMWH) and warfarin for prevention of deep-vein thrombosis after hip or knee replacement. Blood 72:831–840
Hume M, Kuriakose T, Xavier ZI, Turner RH (1973) 125I-fibrinogen and the prevention of venous thrombosis. Arch Surg 107:803–812
International Multicentre Trial (1975) Prevention of fatal postoperative pulmonary embolism by low doses of heparin. Lancet 11:45–51
Kakkar VV, Murray WJG (1985) Efficacy and safety of low molecular weight heparin (CY216) in preventing postoperative venous thromboembolism. Br J Surg 72:786–791
Kakkar VV, Spindler J, Flute PT et al. (1972) Efficacy of low-doses of heparin in prevention of deep-vein thrombosis after major surgery: A double-blind randomized trial. Lancet 11:101–106
Keser C, Groh J, Schramm W, Peter K (1997) Thromboembolieprophylaxe mit Heparinen: Gefahr bei rückenmarknaher Anästhesie? Heparin 11:1–6
Koppenhagen K (1997) Empfehlungen zur stationären und ambulanten Thromboembolie-Prophylaxe in der Chirurgie. Expertengespräch zur Thromboembolie-Prophylaxe. Mitteilungen der Deutschen Gesellschaft für Chirurgie 5, Demeter
Kudsk KA, Fabian TC, Baum S et al. (1989) Silent deep vein thrombosis in immobilized multiple trauma patients. Am J Surg 158:515–519
Lahnborg G, Friman L, Bergstrom K, Lagergren H (1974) Effect of low-dose heparin on incidence of postoperative pulmonary embolism detected by photoscanning. Lancet 1:329–331
Lassen M, Borris L (1995) Prolonged thromboprophylaxis with low molecular weight heparin (Fragmin) after elective total hip arthroplasty -’ a placebo controlled study. Thromb Haemost 73:1104
Lechler E, Schramm W, Flosbach CW (1996) The venous thrombotic risk in non-surgical patients: epidemiological data and efficacy/safety profile of a low-molecular-weight heparin (Enoxaparin). The Prime Study Group. Haemostasis 26 (Suppl 2):49–56
Leizorovicz A, Picolet H, Peyrieux JC, Boissel JP (1991) Prevention of perioperative deep vein thrombosis in general surgery: A multicentre double-blind study comparing two doses of logiparin and standard heparin. Br J Surg 78:412–416
Leizorovicz A, Haugh MC, Chapuis FR et al. (1992) Low molecular weight heparin in the prevention of perioperative thrombosis. Br Med 305:913–920
Levine MN, Hirsh J, Gent et al. (1991) Prevention of deep vein thrombosis after elective hip surgery: A randomized trial comparing low molecular weight heparin with standard unfractionated heparin. Ann Intern Med 114:545–551
Leyvraz PF, Bachmann F, Hoek J et al. (1991) Prevention of deep vein thrombosis after hip replacement: Randomized comparison between unfractionated heparin and low molecular weight heparin. Br Med J 303:543–548
Mannucci PM, Citterio LA, Penajotopoulos N (1976) Low-dose heparin and deep vein thrombosis after total hip replacement. Thromb Haemost 36:157–164
Mätzsch T, Bergqvist D, Fredin H et al. (1991) Comparison of the thromboprophylactic effect of low molecular weight heparin versus dextran in total hip replacement. Thromb Haemorrh Disorders 3:25–29
McCarthy ST, Robertsson D, Turner JJ, Hawkey CJ (1977) Low-dose heparin as a prophylaxis against deep-vein thrombosis after acute stroke. Lancet 11:800–801
Molnar L, Demeter I, Vamosi B, Csornai M (1981) Phlebothrombose der unteren Extremitäten bei Kranken mit Hemiplegie nach zerebralem Insult. Folia Angiol 29:16–19
Morris GK, Mitchell JR (1975) Warfarin sodium in the prevention of deep venous thrombosis and pulmonary embolism in patients with fractured neck of femur. Lancet 11:869–871
Morris GK, Henry APJ, Preston BJ (1974) Prevention of deep-vein thrombosis by low-dose heparin in patients undergoing total hip replacement. Lancet 11:797–801
Moskovitz PA, Ellenberg SS, Feffer HL et al. (1978) Low dose heparin for prevention of venous thromboembolism in total hip arthroplasty and surgical repair of hip fractures. J Bone Joint Surg 60:1065–1070
Nicolaides AN, Dupont PA, Desais S et al. (1972) Small doses of subcutaneous sodium heparin in preventing deep venous thrombosis after major surgery. Lancet 11:890–893
Nurmohamed MT, Rosendaal FR, Büller HR et al. (1991) Low molecular weight heparin versus Standard heparin in general and orthopaedic surgery: a meta-analysis. Lancet 340:152–155
Nylander G, Semb H (1972) Veins of the lower limb after tibial fractures. Surg Gynecol Obstet 134:974–977
Pezzuoli G, Neri Serneri GG, Settembrini P et al. (STEP-Study Group) (1989) Prophylaxis of fatal pulmonary embolism in general surgery using low molecular weight heparin CY 216: A multicentre double-blind randomized controlled clinical trial versus placebo. Int Surg 74:205–214
Pinto DJ (1970) Controlled trial of an anticoagulant (warfarin sodium) in the prevention of venous thrombosis following hip surgery. Br J Surg 57:349–354
Planes A, Vochelle N, Mazas F et al. (1988) Prevention of postoperative venous thrombosis: A randomized trial comparing unfractionated heparin with low molecular weight heparin in patients undergoing total hip replacement. Thromb Haemost 60:407–410
Planes A, Vochelle N, Darmon JY et al. (1996) Risk of deep-venous thrombosis after hospital discharge in patients having undergone total hip replacement: double-blind randomized comparison of Enoxaparin versus placebo. Lancet 348:224–228
Prasad BK, Banerjee AK, Howard H (1982) Incidence of deep vein thrombosis and effect of pneumatic compression of the calf in elderly hemiplegics. Age Ageing 11:42–44
Prins MH, Gelsema R, Sing AK, van Heerala LR, Ottolander GJH (1989) Prophylaxis of deep venous thrombosis with a low-molecular-weight heparin (Kabi 2165/Fragmin) in stroke patients. Haemostasis 19:245–250
Rem J, Duckert F, Fridrich R, Gruber UF (1975) Subkutane kleine Heparindosen zur Thromboseprophylaxe in der allgemeinen Chirurgie und Urologie. Schweiz Med Wo-chenschr 105:827–832
Roise OM, Nurmohamed M, Reijnders P et al. (1993) A multicentre, randomised, assessor-blind, pilot study comparing the efficacy in the prophylaxis of DVT and the safety of Orgaran® (ORG 10172), Fragmin®, Clexane®/Love-nox® in patients undergoing surgery for a fractured hip. Thromb Haemost 69:273 (Abstract)
Rosenberg IL, Evans M, Pollock AV (1975) Prophylaxis of postoperative leg vein thrombosis by low-dose subcutaneous heparin or preoperative calf muscle stimulation. A controlled clinical trial. Br Med J 1:649–651
Samama M, Bernard P, Bonnardot JP et al. (1988) Low molecular weight heparin compared with unfractionated heparin in prevention of postoperative thrombosis. Br J Surg 75:128–134
Scottish Study (1974) A multi-unit controlled trial: heparin versus dextran in the prevention of deep-vein thrombosis. Lancet 11:118–124
Sevitt S, Gallagher NG (1959) Prevention of venous thrombosis and pulmonary embolism in injured patients: a trial of anticoagulant prophylaxis with phenindione in middle-aged and elderly patients with fractured necks of femur. Lancet 11:981–989
Sevitt S, Gallagher N (1961) Venous thrombosis and pulmonary embolism: a clinicopathologic study in injured and burned patients. Br J Surg 45:475–489
Sharnoff JG (1966) Results in the prophylaxis of postoperative thromboembolism. Surg Gynecol Obstet 123:303–307
Spiro TE, Enoxaparin Clinical Trials Group (1991) A randomized trial of enoxaparin administered postoperatively for the prevention of deep vein thrombosis following elective hip replacement. Thromb Haemost 65:824 (Abstract)
Taberner DA, Poller L, Burslem RW, Jones JB (1978) Oral anticoagulants controlled by the British comparative thromboplastin versus low-dose heparin in prophylaxis of deep vein thrombosis. Br Med J 1:272–274
Turpie AGG, Levine MN, Hirsh J et al. (1987) A double-blind randomized trial of ORG 10172 low molecular weight heparinoid in the prevention of deep vein thrombosis in thrombotic stroke. Lancet 1:523–526
Turpie AGG, Levine MN, Powers PJ et al. (1991) A double-blind randomized trial of ORG 10172 low molecular weight heparinoid versus unfractionated heparin in the prevention of deep vein thrombosis in patients with thrombotic stroke. Thromb Haemost 65:753–761
Venous Thrombosis Study Group (1975) Small doses of subcutaneous sodium heparin in the prevention of deep vein thrombosis after elective hip operation. Br J Surg 62:348–352
Warlow C, Ogston D, Douglas AS (1972) Venous thrombosis following strokes. Lancet 1:1305–1306
Warlow C, Beattie AG, Terry G et al. (1973) A double blind trial of low doses of subcutaneous heparin in the prevention of deep vein thrombosis after myocardial infarction. Lancet 11:934–936
Warlow C, Ogston D, Douglas AS (1976) Deep vein thrombosis of the legs after strokes. Br Med J 1:1178–1183
Willen J, Bergqvist D, Hallbrook T (1982) Venous insufficiency as a late complication of tibial fracture. Acta Orthop Scand 53:149–153
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1999 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Harenberg, J., Haas, S., Breddin, K.H. (1999). Prophylaxe der venösen Thrombose. In: Müller-Berghaus, G., Pötzsch, B. (eds) Hämostaseologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-07673-6_79
Download citation
DOI: https://doi.org/10.1007/978-3-662-07673-6_79
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-662-07674-3
Online ISBN: 978-3-662-07673-6
eBook Packages: Springer Book Archive