[Prophylaxis of tromboembolic disease after total hip replacement.].

Total hip replacement represents an operation with high risk of thromboembolic disease. An optimal strategy of thromboprophylaxis is very important. In our two groups of patients we compared two ways of prophylaxis both during hospitalization and after hospital discharge. 81 patients in the first group were treated with low molecular weight heparin (LMWH) - Fraxiparine during the stay in hospital and with a combination of three drugs - Aspirin, Curantyl and Secatoxin during 3 months after operation. 85 patients in the second group were also treated with LMWH during the stay in hospital but LMWH was early changed for Warfarin. Warfarin was taken 3 months after operation. We assessed the occurence of clinical manifest thrombotic events-deep venous thrombosis and pulmonary embolism confirmed by Doppler ultrasonography and perfusion lung scanning. Manifest clinical thrombosis did not occur during hospitalization in the first group of patients but two thrombosis were proven in the second group. Bleeding complications were assessed as well. These complications occurred in two patients during the stay in hospital in the first group, and in three patients in the second group. None of our patients in both groups suffered from a late occurrence of clinically significant thrombosis. Currently we recommend the administration of LMWH during hospitalization, and elastis stockings to all patients after hospital discharge. Patients with higher risk of thrombosis take Warfarin 3 months after operation. Key words: thromboembolic disease, prophylaxis, low molecular weight heparin, total hip replacement.