[Effect of fragmin, a low-molecular heparin, on hemostasis in patients with alimentary-constitutional obesity]

The authors conducted comparative study of the hemostasis indices before and in the immediate period after operation for formation of a small stomach in 31 patients with stage III-IV alimentary-constitutional obesity, in 50 patients without obesity who underwent operation on the stomach, and in 15 volunteers. Nonspecific prevention of thrombogenesis was performed in all patients with normal weight and those with obesity. Patients with obesity were given in addition specific thrombogenesis prevention with nonfractionated heparin (group I) and fractionated low-molecular heparin-fragmin produced by KABI (groups II and III). Study of the parameters of the hemostasis system in the postoperative period showed nonspecific prevention of thrombogenesis to be sufficient to reduce the risk of pulmonary artery phlebothrombosis and embolism in most patients without obesity. In patients with obesity the probability of phlebothrombosis and thromboembolism is much higher, in view of which they must be given heparin in addition to nonspecific prevention. Fragmin, as an agent for thrombosis prevention, has certain advantages over nonfractionated heparin and should be used more frequently in clinical practice in patients of the risk group, e. g. with pathological obesity, in a dose no less than 100 U/kg. With the use of fragmin laboratory control before each injection is not needed. Administration of nonfractionated and fractionated heparins must be combined with bandaging of the lower limbs and other measures of nonspecific prevention of thrombogenesis.