Ouvry P, Arnoult A-C, Genty C, Galanaud J-P, Bosson J-L
Clinique Mégival, 76550 Saint-Aubin-sur-Scie, France.
J Mal Vasc. 2012 Jun;37(3):140-5. doi: 10.1016/j.jmv.2012.02.004. Epub 2012 May 4.
Compression therapy constitutes the cornerstone of prevention of post-thrombotic syndrome in patients with deep-vein thrombosis (DVT). However, no consensus has been reached regarding the optimal timing for initiation, duration, and strength of compression therapy.
To document prescribing practices of compression therapy in case of DVT by French Vascular Medicine physicians.
E-mail survey sent in 2009 to all physicians members of the French Society of Vascular Medicine.
Seven hundred and sixty-one vascular medicine physicians (56.6% private practice, 19.8% hospital-based and 23.6% both private practice and hospital-based physicians) responded. At diagnosis, 94.3% (n=707) systematically prescribed compression therapy. The initial compression consisted in elastic compression stockings (ECS) for 57.3% of patients (n=426) and in bandages for 42.7% (n=317). When physicians initially prescribed bandages, in 92.3% of cases they later switched to elastic compression stockings (ECS). Finally, 95.8% (n=712) of vascular medicine physicians reported prescribing ECS during DVT follow-up. The ECS ankle pressure gradient was 15-20 mmHg in 64.3% of cases and 20-36 mmHg in 35.5%. Most physicians (85.9%, n=631) modulated the duration of compression therapy according to the results of follow-up compression ultrasonographic explorations. Only a limited proportion of physicians took into account thrombus localization or its initial extention.
In case of DVT, French vascular medicine physicians systematically prescribed compression therapy. However, the strength of compression was lower than recommended by international guidelines. Efficacy and benefits (potential better compliance) of this common practice should be assessed with a randomized controlled trial.
压迫疗法是预防深静脉血栓形成（DVT）患者血栓后综合征的基石。然而，关于压迫疗法开始的最佳时机、持续时间和强度尚未达成共识。
记录法国血管医学医生对DVT患者压迫疗法的处方习惯。
2009年通过电子邮件对法国血管医学协会的所有医生会员进行调查。
761名血管医学医生（56.6%为私人执业医生，19.8%为医院医生，23.6%为私人执业与医院双执业医生）回复了调查。在诊断时，94.3%（n = 707）的医生系统地开出了压迫疗法的处方。初始压迫治疗中，57.3%（n = 426）的患者使用弹力袜，42.7%（n = 317）的患者使用绷带。当医生最初开绷带处方时，92.3%的情况下后来会换成弹力袜。最后，95.8%（n = 712）的血管医学医生报告在DVT随访期间开了弹力袜处方。64.3%的病例中，弹力袜的踝部压力梯度为15 - 20 mmHg，35.5%的病例中为20 - 36 mmHg。大多数医生（85.9%，n = 631）根据随访压迫超声检查结果调整压迫治疗的持续时间。只有少数医生考虑血栓的位置或其初始范围。
对于DVT患者，法国血管医学医生系统地开出压迫疗法的处方。然而，压迫强度低于国际指南推荐的水平。这种常见做法的疗效和益处（可能更好的依从性）应通过随机对照试验进行评估。
