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腹主动脉瘤修复术的静脉血栓预防管理存在明显差异;英国血管外科医生调查结果。

Marked variation in venous thromboprophylaxis management for abdominal aortic aneurysm repair; results of survey amongst vascular surgeons in the United kingdom.

机构信息

Cumberland Infirmary, Vascular unit, North Cumbria Acute Hospital Trust, Carlisle, Cumbria CA2 7HY, UK.

出版信息

Eur J Vasc Endovasc Surg. 2011 Nov;42(5):591-5. doi: 10.1016/j.ejvs.2011.05.017. Epub 2011 Jun 24.

Abstract

OBJECTIVES

We aimed to survey the current management of venous thromboprophylaxis in patients undergoing elective surgery for abdominal aortic aneurysm (AAA) by vascular surgeons in the United Kingdom.

DESIGN

A questionnaire was designed to investigate anticoagulation strategies in the perioperative period of elective AAA repair, both open and endovascular. This included both chemical and mechanical prophylaxis. A total of 395 questionnaires was posted to the members of the Vascular Society of Great Britain and Ireland.

RESULTS

One hundred and seventy-two (44%) valid responses were received. Half of the respondents administered pre-operative chemical prophylaxis at a mean of 13 h prior to AAA surgery. There was a high level of concordance in administration of heparin during surgery and in thromboprophylaxis post-operatively, with 97% giving some form of thromboprophylaxis. However there was a variation in the dose and timing, if administered, of chemical and mechanical prophylaxis.

CONCLUSION

The survey revealed diversity in perioperative thromboprophylaxis strategies among vascular surgeons. This suggests that standardisation of pre-operative and post-operative mechanical and chemical thromboprophylaxis may be required which could potentially improve the outcomes in elective management of AAA in the UK.

摘要

目的

我们旨在调查英国血管外科医生在择期手术治疗腹主动脉瘤(AAA)患者中,目前对静脉血栓栓塞症预防的管理情况。

设计

设计了一份问卷,以调查择期 AAA 修复术(开放和血管内)围手术期的抗凝策略,包括化学和机械预防。总共向英国和爱尔兰血管学会的成员邮寄了 395 份问卷。

结果

共收到 172 份(44%)有效回复。一半的受访者在 AAA 手术前平均 13 小时给予术前化学预防。术中给予肝素和术后进行血栓预防具有高度一致性,97%的受访者给予某种形式的血栓预防。然而,如果给予,化学和机械预防的剂量和时间存在差异。

结论

调查显示血管外科医生在围手术期血栓预防策略方面存在多样性。这表明可能需要对术前和术后机械和化学血栓预防进行标准化,这可能会改善英国择期 AAA 管理的结果。

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