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目前的证据和专家意见在膝关节和部完全置换后的血栓预防

Bharat S Mody¹, Manuj Wadhwa², Ronen Roy³

¹Joint Replacement Surgery, Welcare Hospital, Vadodara, IND.

|January 26, 2024

概括

非维生素K对抗剂口服抗凝剂 (NOACs) 在进行关节或膝关节置换手术后有效预防静脉血栓栓塞 (VTE). 这些抗凝血剂在VTE预防和出血风险之间提供了平衡,方便口服.

科学领域:

整形外科整形外科整形外科
药理学药理学是指药理学的学科.
血管外科血管外科

背景情况:

有效的抗凝药对于全关节置换 (THR) 和全膝关节置换 (TKR) 患者的最佳结果至关重要,平衡静脉血栓栓塞 (VTE) 风险和出血.
目前的指导方针并没有为这些程序指定首选的血栓预防剂.

研究的目的:

审查当前关于THR/TKR患者抗凝血的指导方针和证据.
总结关于药理性VTE预防的专家意见,重点关注非维生素K对抗剂口服抗凝剂 (NOAC).

主要方法:

对接受THR和TKR的患者的血栓预防策略的文献综述.
对抗凝血药物有效性和安全性的证据分析,包括NOAC和低分子量肝素 (LMWHs).

主要成果:

在THR/TKR后,NOAC在VTE预防方面表现出与LMWH相似的疗效.
口服和缺乏常规监测使NOAC易于使用,特别是在门诊环境中.
推的持续时间是TKR后两周和THR后五周,延长到手术后六周,以涵盖VTE风险期.

结论:

在THR/TKR后的VTE预防中,NOAC是一种可行的和有效的选择.
针对特定患者群体 (老年人,肥胖者,功能障碍者) 可能需要进行个性化抗凝剂选择,因为对头对头比较数据有限.
专家意见可以帮助解决THR/TKR患者抗凝管理中的差距.

关键词:

深静脉血栓症 (DVT) 是一种疾病.低分子量肝素 (lmwh) 是一种新型口服抗凝剂新型口服抗凝剂整体关节置换 (thr) 的情况整体膝关节置换 (tkr) 的情况静脉血栓塞栓症 (VTE) 是一种

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