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阿司匹林:患者真的在服用吗?——一项质量评估研究。

Aspirin: are patients actually taking it?-A quality assessment study.

作者信息

Lewis Steven, Kink Shaun, Rahl Michael, Nord Ashley, Meldau Jason, Roberts Karl

机构信息

Spectrum Health Orthopaedic Surgery Residency, Grand Rapids, MI, USA.

Michigan State University College of Human Medicine, Grand Rapids, MI, USA.

出版信息

Arthroplast Today. 2018 Sep 3;4(4):475-478. doi: 10.1016/j.artd.2018.07.006. eCollection 2018 Dec.

Abstract

BACKGROUND

The purpose of the study was to assess patient adherence to an aspirin-based prophylactic deep venous thromboembolism (DVT) care management plan after total lower extremity arthroplasty.

METHODS

Using a cross-sectional study design, patients who underwent total hip or knee replacement surgery by a single senior surgeon were surveyed at their routine 6-week follow-up appointment regarding adherence to aspirin DVT prophylaxis. Postoperatively, patients were advised to take 325 mg of aspirin twice daily for 6 weeks to prevent DVT.

RESULTS

Of the 101 patients surveyed, 45 underwent total hip arthroplasty while 56 underwent total knee arthroplasty. There were 48 (48%) patients who were still taking aspirin at their routine 6-week postoperative follow-up appointment and 53 (52%) patients who were not taking aspirin (nonadherent group). Of the latter, 3 (6%) never took aspirin postoperatively, 14 (26%) discontinued within 2 weeks postoperatively, and 23 (43%) did not take it any longer for half the time prescribed. In the nonadherent group, 8 patients reported that they felt they did not need the aspirin prophylaxis, 5 experienced side effects, and 10 were unsure of how long they needed to take it. There was 1 patient with a calf DVT and no episodes of pulmonary embolism.

CONCLUSIONS

Over half of our study, patients did not finish their aspirin regimen. We suggest a consistent outline of medication duration throughout the pre/postop course and communication regarding aspirin cessation.

摘要

背景

本研究的目的是评估全下肢关节置换术后患者对基于阿司匹林的预防性深静脉血栓形成(DVT)护理管理计划的依从性。

方法

采用横断面研究设计,对由一位资深外科医生进行全髋关节或膝关节置换手术的患者在术后6周的常规随访中就阿司匹林预防DVT的依从性进行调查。术后,建议患者每天服用两次325毫克阿司匹林,持续6周以预防DVT。

结果

在接受调查的101例患者中,45例行全髋关节置换术,56例行全膝关节置换术。在术后6周的常规随访中有48例(48%)患者仍在服用阿司匹林,53例(52%)患者未服用阿司匹林(非依从组)。在后者中,3例(6%)术后从未服用阿司匹林,14例(26%)在术后2周内停药,23例(43%)在规定时间的一半后不再服用。在非依从组中,8例患者表示他们觉得不需要服用阿司匹林进行预防,5例出现了副作用,10例不确定需要服用多长时间。有1例患者发生小腿DVT,无肺栓塞事件。

结论

在我们的研究中,超过一半的患者没有完成阿司匹林疗程。我们建议在整个术前/术后过程中对用药持续时间制定一致的概述,并就停用阿司匹林进行沟通。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02cb/6287232/6990071b44fe/gr1.jpg

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