Influence Of Prophylactic Treatment With Low Molecular Weight Heparin (Lmwh) On The Coagulation System In Patients With Total Hip Replacement

Author(s): 
Varvarigos N, Kamaradou E, Potamianou A, Dermon A, Trontzas P, and Tsiroglou E.
Asklipieion General Hospital, Athens (Greece).
Text: 
AIM of this study was to find the changes of the parameters of fibrinolytic and coagulation system in patients with total hip replacement which are preventively given heparins of low molecular weight (LMWH), the first days after surgery.
Patients and methods. We studied 16 patients (3 men-13 women aged 65 ± 18 years old), who had done total hip replacement. In these patients LMWH (Nadroparin calcium 7500 units) was given 12 hours before surgery and once daily after the surgery Blood was taken before surgery and the 1st, 2nd and 7th day after surgery. Plasminogen, t-PA antigen, PAI-1,FPA, PT, aPTT, Fibrinogen, ATIII and PF4 were measured and analysed by SPSS statistic program, using the Wilcoxon matched-pairs signed-ranks tests.
Results. 1. For the Fibrinolytic system: Mean values oft-PA antigen, PAI-1 and FP A raise after surgery statistically significant compared to these before surgery (t-PA antigen: n=0.03, PAI-1:n=0.01 and FP A: n=0.02), while Plasminogen decrease. 2. For the coagulation system: Mean values of PT and aPTT are increased, while Fibrinogen, A TIIl and PF4 decrease after surgery statistically significant compared to these before surgery (PT: n=0.01, aPTT: n=0.05, PF4: n=0.01, A Tlll: n=0.002 ).
Conclusion. The above changes of the parameters of fibrinolytic and coagulation system in these patients are very useful and help to prevent thrombosis, a common complication in this surgery.
Literature: 
Influence of prophylactic treatment with low molecular weight heparin (LMWH) on the coagulation system in patients with total hip replacement