[在老年患者中正确使用口服抗凝剂]
1Court séjour gériatrique -Hôpital Charles-Foix, Groupe hospitalier AP-HP -Sorbonne Université, 7, avenue de la République, 94205 Ivry-sur-Seine, France; UFR de médecine, Sorbonne Université, Paris, France; UMR université Paris Cité, Inserm, Innovations thérapeutiques en hémostase, Paris, France.
Soins. Gerontologie
|September 16, 2023
概括
直接口服抗凝剂 (DOAC) 的使用越来越多,但维生素K抑制剂 (VKA) 仍然很重要. 谨慎的VKA使用和对脆弱患者的DOAC风险的认识对于安全的抗凝药是必不可少的.
科学领域:
- 药理学和治疗学 药理学和治疗学
- 心脏病学 心脏病学
- 血液学 血液学 血液学
背景情况:
- 直接口服抗凝剂 (DOAC) 越来越多地比维生素K对抗剂 (VKA) 更受欢迎.
- 患有心房动和静脉血栓塞栓症的老年患者是这些疗法的主要使用者.
- 尽管DOAC取得了进展,但VKAs仍然保留了特定的指示,需要谨慎管理.
研究的目的:
- 突出维生素K对抗剂 (VKA) 在特定临床场景中的持续相关性.
- 强调直接口服抗凝剂 (DOAC) 的谨慎处方和处理的重要性.
- 为了应对脆弱的老年患者与并发症和多药物的抗凝管理中的特殊挑战.
主要方法:
- 审查当前的抗凝血指南和临床实践趋势.
- 对从VKAs和DOAC中受益的患者群体的分析.
- 对复杂患者中DOAC的安全性概况和管理考虑的审查.
主要成果:
- 在主要的指示中,DOAC正在取代VKA,特别是在老年人中.
- 对于某些患者群体和某些适应症,VKA仍然是必要的.
- 由于潜在的风险,DOACs需要仔细考虑,特别是在患有多种并发症和药物的脆弱患者中.
结论:
- 虽然DOACs很普遍,但对VKA使用的彻底理解仍然是必不可少的.
- 处方DOACs需要意识到他们的特定风险和处理细微差别.
- 需要特别注意老年,并发病和多药患者的抗凝药管理,以确保安全性和有效性.
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