旅行者血栓症——德国的一种实践现状。

Travelers' thrombosis--a state of practice in Germany.

机构信息

Department of Transfusion Medicine and Hemostaseology, University Hospital Erlangen, Krankenhausstraβe 12, Erlangen, Germany.

出版信息

J Travel Med. 2011 Jan-Feb;18(1):44-52. doi: 10.1111/j.1708-8305.2010.00482.x. Epub 2010 Dec 1.

DOI:10.1111/j.1708-8305.2010.00482.x

PMID:21199142

Abstract

BACKGROUND

Evidence-based guidelines to prevent travelers' thrombosis (TT) are still missing. We wanted to know whether travelers perceive the risk of TT, how they and their physicians cope with this in daily life, and whether recommended thrombosis prophylaxis (TP) was actually performed.

METHODS

A standardized questionnaire (Q1) asking for age, gender, travel habits, and the assessment of the risk of TT was given to randomly incoming travelers seeking for travel medicine advice prior to long haul travel. A second questionnaire (Q3) focusing on the actually performed TP was answered by these travelers after return. The physician assessed travelers' thrombosis risk (TR) and gave specific recommendations for TP in questionnaire Q2. Besides analysis of age, gender, the awareness of the risk of TT, travelers' TR, duration, and kind of travel, we compared performed and recommended TP and analyzed the influence of relevant factors on TP.

RESULT

A total of 315 travelers (43.3% male, aged 43.2 ± 15.9 y) took part in this survey. We received responses from 275, 309, and 248 travelers who answered Q1, Q2, and Q3, respectively. Travelers (91.6%) were aware of the risk of TT which was significantly higher among travelers aged 60 years and older. Travelers' TR had a significant influence on recommended and performed TP (p < 0.001). We found a moderate agreement between recommended and performed TP (kappa coefficient = 0.54). More travelers than recommended performed a specific TP (49.6% vs 39.8%) which was mainly done by the intake of acetylsalicylic acid (ASA).

CONCLUSIONS

Travelers are well aware of the risk of TT and are compliant to perform at least the recommended TP for which physicians predominantly consider travelers' TR. The high rate of non-recommended intake of ASA and the different dosage regimes recommended for TP with ASA or heparin, however, indicate the need of better information for travelers and physicians.

摘要

背景

目前仍缺乏预防旅行者血栓形成（TT）的循证指南。我们想了解旅行者对 TT 风险的认知程度，他们和他们的医生在日常生活中如何应对这一风险，以及推荐的血栓预防（TP）是否真正实施。

方法

我们向随机前来寻求长途旅行前旅行医学咨询的旅行者发放了一份标准化问卷（Q1），内容包括年龄、性别、旅行习惯以及对 TT 风险的评估。这些旅行者在返回后回答了另一份重点关注实际实施的 TP 的问卷（Q3）。医生在问卷（Q2）中评估旅行者的血栓风险（TR）并给出具体的 TP 建议。除了分析年龄、性别、对 TT 风险的认识、旅行者的 TR、旅行的持续时间和类型外，我们还比较了实际实施的和推荐的 TP，并分析了相关因素对 TP 的影响。

结果

共有 315 名旅行者（43.3%为男性，年龄 43.2±15.9 岁）参与了这项调查。我们收到了 275、309 和 248 名旅行者对 Q1、Q2 和 Q3 的回复，分别占 91.6%、96.0%和 81.2%。旅行者（91.6%）意识到 TT 的风险，而年龄在 60 岁及以上的旅行者对此风险的认识明显更高。旅行者的 TR 对推荐和实施的 TP 有显著影响（p<0.001）。我们发现推荐和实施的 TP 之间存在中等程度的一致性（kappa 系数=0.54）。实施 TP 的旅行者比例高于推荐的比例（49.6% vs 39.8%），主要是通过服用乙酰水杨酸（ASA）来实现。