在DOAC时代,我如何治疗儿科静脉血栓塞栓症
Rukhmi V Bhat1, Guy Young2, Anjali A Sharathkumar3
1Center for Cancer and Blood Disorders, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL.
Blood
|June 30, 2023
概括
直接口服抗凝剂 (DOAC) 为儿科静脉血栓塞栓症 (VTE) 治疗提供了方便的替代方案,但儿童的有限数据需要仔细的临床考虑和成人研究的推断.
科学领域:
- 儿科血液学 儿科血液学
- 药理学 药理学是指药理学的学科.
- 血栓形成的管理
背景情况:
- 直接口服抗凝剂 (DOAC) 如利瓦洛克萨班和达比加特兰现在已批准用于儿科静脉血栓塞栓症 (VTE).
- 与传统抗凝剂相比,DOACs具有优势,包括口服和减少监测.
- 有关治疗监测和儿童未经批准的逆转药物的缺乏存在担忧.
研究的目的:
- 通过DOACs分享管理儿科抗凝药的临床经验.
- 解决血液学家在日常实践中面临的实际挑战.
- 提供关于在特殊儿科群体和复杂情景中使用DOAC的指导.
主要方法:
- 对四个涉及DOACs的不同儿科病例的临床实践和管理的审查.
- 讨论关键方面,包括适应性,特殊群体,实验室监测和药物相互作用.
- 探索术后管理和抗凝固逆转策略.
主要成果:
- 在成年人中积累了DOACs的经验与儿科的稀疏数据形成鲜明对比,特别是在患有并发症的儿童中.
- 临床医生通常依靠成人数据推断和个人经验来对儿科DOAC使用.
- 这篇文章讨论了在使用DOAC治疗儿科VTE时遇到的具体情况.
结论:
- DOACs代表了儿科抗凝药的重大进步,提供了更好的便利.
- 仔细考虑安全问题,包括监控和逆转,至关重要.
- 需要进一步的研究和经验分享,以优化多种儿科患者的DOAC使用.
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