Schonenberg D, van Meeteren M, Nelissen R G, van der Horst-Bruinsma I E, Pöll R G, Nurmohamed M T
Afd. Reumatologie, VU Medisch Centrum, Postbus 7057, 1007 MB Amsterdam.
Ned Tijdschr Geneeskd. 2003 Sep 20;147(38):1856-60.
Establish the use of thromboprophylaxis in orthopaedic surgery both during and after the hospital admission.
Cross-sectional study.
In April 2002, a letter was sent to all orthopaedic surgeons in the Netherlands announcing that at every hospital with a Department of Orthopaedic Surgery, an orthopaedic surgeon would be approached for a telephone survey. They were phoned in the months April-June 2002. This study included hospitals where major orthopaedic surgery (e.g. the insertion of hip or knee prostheses and hip fracture surgery) took place (n = 124) as well as clinics that only performed day treatments (n = 5).
For major orthopaedic operations, 91% of the hospitals used low molecular weight heparin (LMWH) during the admission period: 36% as monotherapy and 55% in combination with coumarin derivates. In 85% of cases the use of LMWH was started preoperatively. Coumarin derivates were used as a monotherapy in 9% of the hospitals. In 37% of the hospitals the use of NSAIDs was continued, particularly in patients with rheumatoid arthritis. In 94% of the hospitals, the use of acetylsalicylic acid was always stopped. In 97% of the hospitals prophylaxis was given after discharge in the form of LMWH (37% of the cases) or coumarin derivates (63% of the cases). The use of thromboprophylaxis with respect to arthroscopies and plaster immobilisation was variable.
确定骨科手术住院期间及出院后血栓预防措施的使用情况。
横断面研究。
2002年4月，向荷兰所有骨科外科医生发送了一封信，宣布在每个设有骨科手术科室的医院，将联系一名骨科外科医生进行电话调查。在2002年4月至6月期间对他们进行了电话访问。本研究包括进行大型骨科手术（如髋关节或膝关节假体植入及髋部骨折手术）的医院（n = 124）以及仅进行日间治疗的诊所（n = 5）。
对于大型骨科手术，91%的医院在住院期间使用低分子量肝素（LMWH）：36%作为单一疗法，55%与香豆素衍生物联合使用。85%的病例在术前开始使用LMWH。9%的医院将香豆素衍生物作为单一疗法使用。37%的医院继续使用非甾体抗炎药（NSAIDs），特别是类风湿性关节炎患者。94%的医院总是停止使用乙酰水杨酸。97%的医院在出院后以LMWH（37%的病例）或香豆素衍生物（63%的病例）的形式进行预防。关节镜检查和石膏固定的血栓预防措施使用情况各不相同。
