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在外科手术期间的血栓预防实践的变化:指南是否需要更仔细的观察?
Russell Seth Martins1, Elizabeth Christophel2, Kostantinos Poulikidis1
1Division of Thoracic Surgery, Department of Surgery, Hackensack Meridian Health Network, Hackensack, New Jersey.
Annals of thoracic surgery short reports
|January 10, 2025
概括
大多数美国胸部外科医生偏离了2022年关于癌症患者VTE预防的指导方针. 扩展术后预防很少使用,这表明需要重新评估当前的做法,并探索新的药物.
科学领域:
- 胸部外科手术 胸部外科手术
- 在瘤学瘤学.
- 血管外科 血管外科
背景情况:
- 在胸腺癌患者的外科手术期静脉血栓栓塞 (VTE) 预防的联合指南由AATS和ESTS于2022年发布.
- 本研究评估了公布一年后遵守这些指南的情况.
研究的目的:
- 在美国胸部外科医生中评估VTE预防的当前做法.
- 为了确定遵守2022年AATS/ESTS指南的程度.
主要方法:
- 在美国,在经过董事会认证/符合条件的胸部外科医生中进行了一项调查.
- 数据是在2023年7月至10月期间收集的.
主要成果:
- 在103名接受调查的外科医生中,超过一半的外科医生经常使用手术前的VTE化学预防.
- 大多数人将术后预防限制在住院,很少在出院后延长.
- 低分子量肝素 (LMWH) 是使用时扩展预防的首选药物.
结论:
- 大多数美国胸部外科医生并不经常开设延长术后静脉瘤预防,这与2022年的指导方针相反.
- 重新评估延长型血栓预防的必要性被强调,因为在最小侵入性手术中恢复能力提高.
- 需要进一步的研究,包括关于扩展预防的RCT和像DOACs这样的新药的RCT.
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