Department of Orthopaedic Surgery, St. George Hospital, Sydney, Australia.
J Arthroplasty. 2012 Feb;27(2):173-9. doi: 10.1016/j.arth.2011.05.003. Epub 2011 Jul 12.
Previous surveys of orthopedic surgeons have shown considerable variation in thromboprophylaxis for venous thromboembolism after joint arthroplasty. This survey aimed to determine the current practice among Australian orthopedic surgeons. A questionnaire regarding the duration, reasons, and methods of chemical and mechanical prophylaxis for hip and knee arthroplasty patients was sent to the 1082 surgeons identified; 593 (55%) members completed the questionnaire. The survey revealed that 98% of surgeons used chemical thromboprophylaxis, mainly low-molecular-weight heparin (84% hip and 79% knee). Those who use low-molecular-weight heparin were more likely to prescribe anticoagulants in fear of litigation (19.2% vs 10.1%, P = .04) and more likely to rely on protocols or guidelines (32.2% vs 17.2%, P = .004) instead of basing their decision on their own reading (52.4% vs 71.3%, P = .001). Most orthopedic surgeons in our survey have indicated that they would welcome guidelines from their association or college regarding thromboprophylaxis in arthroplasty.
先前对矫形外科医生的调查显示，关节置换术后预防静脉血栓栓塞症的抗血栓形成治疗存在相当大的差异。本调查旨在确定澳大利亚矫形外科医生的当前实践情况。向确定的 1082 名外科医生发送了一份关于髋关节和膝关节置换术患者化学和机械预防的持续时间、原因和方法的问卷；有 593 名（55%）成员完成了问卷。调查显示，98%的外科医生使用化学血栓预防，主要是低分子量肝素（84%髋关节和 79%膝关节）。那些使用低分子量肝素的人更有可能因为担心诉讼（19.2%比 10.1%，P =.04）而开抗凝剂，更有可能依赖方案或指南（32.2%比 17.2%，P =.004），而不是根据自己的阅读来决定（52.4%比 71.3%，P =.001）。我们调查中的大多数矫形外科医生表示，他们希望协会或学院就关节置换术的抗血栓形成治疗提供指南。
