Resumo

QUIROS M, Gerardo  e  ZAMORA MORERA, Marco V. Uso de heparinas de bajo peso molecular en el manejo ambulatorio de pacientes con trombosis venosa profunda. Estudio comparativo: heparina no fraccionada vs heparina de bajo peso molecular. Rev. costarric. cardiol [online]. 2001, vol.3, n.2, pp.08-13. ISSN 1409-4142.

Background: a comparative study was carried out on the use of intravenous Unfractionated heparin, administered inside the hospital in continuos infusion versus the subcutaneous low -molecular - weight heparin. Clinical and economical aspects are analyzed in both groups of patients. Methods: Prospective study of two groups of 20 patients each randomly chosen during 1 year. The diagnosis was made by duplex ultasound. The first group was treated whit low molecular weight heparin. (Nadroparin ) in subcutaneous doses of 0.6 cc (5700 UI Axa )of the standard doses every 12 hours during tree days. 15 mg of oral warfarin was also initiated the first day followed by 10 mg the second day and 5mg the following days. Prothrombin time (PT), thromboplastin time (TPT)and international normalized ratio (INR)were monitored on the fourth day during the external medical check/up. The second group was hospitalized with intravenous administration of non-fractioned heparin and received adequate control of their PT, TPT and INR until reaching optimal levels. Results: Patients who received low molecular heparin did not require formal hospitalization due to the absence of complications and the economical cost of treatment was only 20% of the total cost reported in the group that did require hospitalization. The group treated whit non-fractioned heparin presented rethrombosis (15%), pulmonary embolism (5%) and minor bleedings (10%), which did not alter the hemodinamical state.

Palavras-chave : Deep venous thrombosis; low molecular weight; heparin; home treatment; economical cost unfractionated.