1ml low molecular weight heparin is equivalent to 9500IU anticoagulant factor Xa. In prevention and treatment, low molecular weight heparin should be administered by subcutaneous injection. In hemodialysis, drugs are administered by intravenous injection. Can not be used for intramuscular injection. During spinal anesthesia/epidural anesthesia or lumbar puncture, the timing of administration of low molecular weight heparin should follow special precautions (see precautions) [u] subcutaneous injection technology [/u] When subcutaneous injection is performed, the patient is prone, and the injection site is in the subcutaneous adipose tissue of the anterolateral or posterolateral abdominal wall, alternately left and right. The injection needle should be inserted vertically and completely into the skin folds picked up by the thumb and forefinger of the syringe, not horizontally. During the whole injection process, skin wrinkles should be maintained. Preventive treatment The following suggestions are usually applicable to all patients undergoing general anesthesia surgery. Patients undergoing surgery under epidural anesthesia may theoretically increase the possibility of epidural hematoma formation, so whether to inject before operation should be considered as appropriate. Frequency of use: once a day Dosage: * Surgery with moderate risk of thromboembolism For surgery with moderate risk of thromboembolism, and the patient does not show serious risk of thromboembolism, injection of 2850IU(0.3ml) per day can effectively play a preventive role. The first injection was made 2 hours before operation. * Surgery with high risk of thromboembolism: The dosage used in hip and knee surgery should be adjusted according to the patient's weight. The daily injection dose is: 38 iu/kg-for example, 12 hours before operation-for example, 12 hours after operation-and then used daily until the third day after operation, and the dose is adjusted to 57IU/kg from the fourth day after operation. Dose and weight (kg) can be determined from the following table according to the patient's weight range: from preoperative to postoperative day three, once a day, once a time, once a time, once a time, once a time, once a time, once a time, once a time, once a time, once a time, once a time. 2850IU(0.3ml) of low molecular weight heparin is enough. Duration of treatment: Anticoagulant treatment time is selected according to the risk of thromboembolism. For all cases, this treatment can assist other standard treatment methods, such as elastic socks for lower limbs, until the patient can walk completely. For general surgery, the average use time of heparin is less than 10 day. Some orthopedic operations, especially hip surgery, can continue to use heparin or oral anticoagulants if long-term anticoagulation treatment is needed. However, so far, the relative risks associated with these treatments have not been evaluated. Laboratory monitoring: [u] Platelet count must be monitored during heparin treatment (see precautions). [/u] Under normal circumstances, the preventive dose of low molecular weight heparin does not affect the activated partial thromboplastin time (APTT). Therefore, it is meaningless to detect this index during treatment, and it is not necessary to detect the activity of anticoagulant factor Xa. Therapeutic drugs * If there is any doubt about the treatment of deep vein thrombosis, it should be determined by appropriate testing methods as soon as possible. Frequency of use: twice a day with an interval of 12 hours. Dosage: 85IU/kg per injection can be injected every 12 hours according to the patient's weight range. See the weight in the table below. The speed of each time Belinda R 40-49KG 0.4 ml 50-59KG 0.5 ml 60-69KG 0.6 ml 70-79KG 0.7 ml 80-89KG 0.8 ml 90-99KG 0.9 ml ≥100KG65. 438+0.0ml When selecting the dose corresponding to the patient's weight, the syringe should be vertical, and the push rod should be adjusted to the required scale to obtain the required injection dose. It should be noted that it is difficult to estimate the dose of patients weighing more than 100kg or less than 40kg, and there may be insufficient dose of low molecular weight heparin or bleeding symptoms, so clinical observation should be strengthened for such patients. Treatment duration: the use time of low molecular weight heparin shall not exceed 10 day. Including the time to reach equilibrium with anti-vitamin K preparation (see notes for monitoring platelet count). Unless there are contraindications, oral anticoagulants should be used as soon as possible. * Treatment of unstable angina pectoris and non-Q-wave myocardial infarction [u] Subcutaneous injection of [/u]86IU anti-Xa factor /kg low molecular weight heparin twice a day (interval 12 hours), combined with aspirin (recommended dose: 75-325mg after loading dose 160-325mg). The initial dose of 86IU anti-Xa factor /kg can be administered by intravenous injection and subcutaneous injection. The treatment time is generally about 6 days, achieving clinical stability. Adjust the dosage according to the patient's weight range to treat unstable angina pectoris and non-Q wave myocardial infarction. The initial injection dose (kg) is a one-time intravenous subcutaneous injection (every 12 hours) < 500.4 ml 0.4 ml 5 1-59. 0.5 ml 0.5 ml 60-69 0.6 ml 0.6 ml 70-79 0.7 ml 0.7 ml 80-89 0.8 ml 90-99 0.9 ml 0.9 ml ≥10010.0 ml because there is no clinical data of low molecular weight heparin combined with thrombolytic drugs, Laboratory monitoring: [u] It is necessary to monitor the platelet count during the whole heparin treatment (see precautions). [/u] It may be necessary to determine the activity of anticoagulant factor Xa (preferably amide decomposition method) to estimate the individual sensitivity of patients, especially those who are clinically ineffective, bleeding or have renal damage. Blood samples were collected between 3 and 4 hours after heparin injection on the second day of treatment, and the detection value was generally 0.5- 1IU anticoagulant factor Xa/ml. Hemodialysis by vascular injection For patients who have no risk of bleeding or hemodialysis lasts for about 4 hours, about 65IU/kg of low molecular weight heparin should be injected through the arterial end at the beginning of dialysis. The dosage can be adjusted according to the patient's weight range, and if necessary, according to the patient's personal situation or hemodialysis technical conditions. If there is a risk of bleeding, the standard dose can be halved.