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在重建性微手术中基于证据的抗凝方法 - - 一个系统的文献综述

Niklas Biermann¹, Juy Chi Chak¹, Anna Wiesmeier¹

¹Department of Plastic, Hand- and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, D-93053 Regensburg, Germany.

Life (Basel, Switzerland)

|January 23, 2024

概括

微手术中的抗凝剂对于预防片失效至关重要,但会带来出血风险. 低剂量肝素或阿司匹林的存活率相似,而高剂量增加了损失.

科学领域:

微手术微手术是一种微手术.
血管外科血管外科
药理学药理学是指药理学的学科.

背景情况:

血栓并发症是微手术中片失败的主要原因之一.
为了预防血栓形成,平衡抗凝药与出血风险至关重要.

研究的目的:

系统地审查微手术过程中的抗凝策略.
评估不同抗凝剂在自由重建和再植入中的有效性和安全性.

主要方法:

在PubMed的系统文献搜索中进行临床和动物研究.
使用修改后的科尔曼方法评分对79篇相关文章的评价.
对阿司匹林,肝素和德克斯治疗方案的临床研究的元分析.

主要成果:

肝素和阿司匹林表现出类似的损失率.
高剂量的肝素或达尔特帕林与低剂量相比,与增加的片损失相关.
由于系统性并发症,不建议使用德克斯;动物研究表明局部/内肝素有益于片的存活率.

结论:

目前的证据表明,低剂量抗凝剂可能是最佳的,但研究质量较低.
需要进一步的大型,多机构的随机临床试验,以建立基于证据的指导方针,用于微手术中的抗凝剂.

关键词:

抗凝固剂是一种抗凝固剂.阿司匹林是一种阿司匹林.达尔特帕林的使用方法片的生存率片的生存率免费的板可以免费使用.肝素是一种肝素.微手术是一种微手术.移植手术是重植的手术.系统性审查系统性审查血栓形成的预防和预防.

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