与癌症相关的血栓栓塞的抗凝固药物治疗
Isabelle Mahé1, Didier Mayeur2, Francis Couturaud3
1Service de Médecine Interne, Hôpital Louis-Mourier, AP-HP, Colombes, France; Université Paris Cité, Inserm UMR S1140, innovations thérapeutiques en hémostase, Paris, France; F-CRIN INNOVTE network, Saint-Etienne, France.
Archives of cardiovascular diseases
|December 13, 2023
概括
发生静脉血栓栓塞 (VTE) 的癌症患者需要仔细选择抗凝剂. 建议使用阿皮克萨班或低分子量肝素作为至少六个月的初始治疗,并定期重新评估.
科学领域:
- 在瘤学瘤学.
- 血液学 血液学 血液学
- 药理学 药理学是指药理学的学科.
背景情况:
- 静脉血栓栓塞 (VTE) 是癌症患者常见且危及生命的并发症.
- 在癌症患者中,对静脉血症的抗凝固药物治疗具有复发和出血的双重风险.
- 最佳的抗凝剂选择对于平衡有效性和安全性至关重要.
研究的目的:
- 概述癌症和静脉血栓炎患者的最佳抗凝剂策略.
- 强调影响抗凝剂选择和持续时间的因素.
- 为了指导临床决策在管理VTE在这个高风险人群.
主要方法:
- 对患者相关因素的审查 (功能状态,年龄,BMI,血小板,功能).
- 考虑VTE相关的因素 (严重程度,部位).
- 评估与癌症相关的因素 (活动,进展) 和治疗相互作用.
- 多学科团队评估和患者偏好的整合.
主要成果:
- 对大多数患者来说,阿皮克萨班或低分子量肝素是建议的初始抗凝剂选择.
- 在患有活跃癌症的患者中,应提供至少六个月的抗凝药治疗.
- 需要定期重新评估,以根据需要调整或停止治疗.
结论:
- 针对个体的抗凝剂治疗选择对于患有VTE的癌症患者至关重要.
- 如果癌症活跃或VTE复发,治疗时间应超过6个月.
- 六个月以上的持续抗凝药需要与瘤学家协商,进行仔细的个人评估.
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