我如何治疗老年人·威莱布兰德乱的治疗方法
Jacqueline N Poston1,2, Rebecca Kruse-Jarres3,4
1Division of Hematology/Oncology, Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT.
Blood
|September 6, 2023
概括
·威尔布兰德病 (VWD) 是一种常见的出血障碍. 在老年人中进行治疗需要仔细考虑出血史,实验室结果,并谨慎使用德斯摩素 (DDAVP),偏好抗纤维素催化剂和因子缩剂.
科学领域:
- 血液学 血液学 血液学
- 内部医学 内部医学
- 老年病的医生 老年病的医生
背景情况:
- ·威尔布兰德病 (VWD) 是最常见的出血障碍,较温和的形式通常在专业中心之外进行管理.
- 随着年龄的增长,威尔布兰德因子 (VWF) 水平可能会受到影响,但这种增加并不总是与出血风险相关联.
- 获得的·威尔布兰德综合征 (AVWS) 经常被忽视,特别是在患有等离子体细胞失光症等疾病的老年患者中.
研究的目的:
- 审查老年人威尔布兰德病的静血管理.
- 突出在老龄化人口中获得的·维勒布兰德综合征的诊断和治疗考虑因素.
主要方法:
- 文献综述侧重于老年患者的VWD和AVWS管理.
- 对影响老年人出血风险和治疗疗效的因素的分析.
- 在这个人群中评估常见的静血剂的安全性概况.
主要成果:
- 最近的出血史和实验室结果对于手术静血治疗决策至关重要.
- 抗纤维解药通常对老年人来说是安全的; 德斯莫普列辛 (DDAVP) 需要谨慎的管理.
- 当必要时,因子缩是一种可行的治疗选择.
- 静脉注射免疫球蛋白 (IVIG) 可以治疗AVWS,但可能会增加血栓形成的风险.
结论:
- 老年人VWD的静血管理需要个性化的方法,平衡出血风险和治疗安全性.
- 获得的VWS是老年人诊断不足的疾病,需要保持警,特别是伴随疾病.
- 仔细考虑治疗选择,包括AVWS的IVIG,对于优化结果而降低风险至关重要.
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