Jones D R
Countess of Chester Hospital.
Ann R Coll Surg Engl. 1991 Jul;73(4):219-21; discussion 222.
A survey of usage and attitudes to thromboembolic prophylaxis among 46 general surgeons in the Mersey Region found that 87% use either low-dose heparin, graduated compression stockings or both on a regular basis for their major cases. However, there was a wide variation of usage: 9 (19.6%) always used heparin in combination with thromboembolic stockings, 4 (8.7%) always used heparin alone, no surgeon used thromboembolic stockings alone. A total of 18 (39%) used thromboembolic stockings in combination with heparin, one-half of them selectively. A further 24% of surgeons used either low-dose heparin or thromboembolic stockings or both on selected patients. Current literature beliefs concerning the efficacy of low-dose heparin and thromboembolic stockings showed a similar variation, with 13% of surgeons believing that the efficacy of low-dose heparin against postoperative deep vein thrombosis has not been shown, 22% believing that thromboembolic stockings were ineffective against postoperative deep vein thrombosis, and 24% believing that low-dose heparin was of no value as a prophylactic agent against postoperative pulmonary embolism. Published meta-analysis has shown these beliefs to be wrong.
对默西地区46位普通外科医生进行的一项关于血栓栓塞预防措施使用情况及态度的调查发现，87%的医生在其主要病例中定期使用低剂量肝素、分级压力弹力袜或两者兼用。然而，使用情况存在很大差异：9位（19.6%）医生总是将肝素与血栓栓塞弹力袜联合使用，4位（8.7%）医生总是单独使用肝素，没有医生单独使用血栓栓塞弹力袜。共有18位（39%）医生将血栓栓塞弹力袜与肝素联合使用，其中一半是选择性使用。另外24%的医生在部分患者中使用低剂量肝素或血栓栓塞弹力袜或两者兼用。当前关于低剂量肝素和血栓栓塞弹力袜疗效的文献观点也存在类似差异，13%的医生认为低剂量肝素预防术后深静脉血栓形成的疗效尚未得到证实，22%的医生认为血栓栓塞弹力袜对术后深静脉血栓形成无效，24%的医生认为低剂量肝素作为预防术后肺栓塞的药物没有价值。已发表的荟萃分析表明这些观点是错误的。
