在DOACs下的近端大腿骨骨折患者的管理
Marc Maegele1,2
1Department for Trauma and Orthopedic Surgery, Cologne-Merheim Medical Center (CMMC), Witten/Herdecke University, Campus Cologne-Merheim, Ostmerheimer Str. 200, 51109, Cologne, Germany. Marc.Maegele@t-online.de.
概括
直接口服抗凝剂 (DOACs) 不应常规延迟靠近大腿骨骨折的手术. 早期手术对于服用DOAC的患者来说通常是安全的,如果需要,可以使用逆转剂.
科学领域:
- 整形外科手术 整形外科手术
- 药理学 药理学是指药理学的学科.
- 老年医学 老年医学
背景情况:
- 伤害前直接口服抗凝剂 (DOAC) 的使用与近接大腿骨骨折的延迟手术有关,可能会恶化结果.
- 现有的指导方针并未全面解决这些患者的术后管理问题.
- 及时的手术干预对于近端大腿骨骨折病例的良好结果至关重要.
研究的目的:
- 在受伤前的DOAC上审查有关近端大腿骨折患者安全手术时间的证据.
- 在必要时概述紧急DOAC逆转的治疗选择.
- 为管理这些复杂的外科病例提供指导.
主要方法:
- 这项研究采用了叙事审查方法.
- 进行了对相关文献的选择性审查.
主要成果:
- 在DOAC患者的近端股骨骨折的早期手术通常是安全的医疗后清除.
- 可能会增加对血液制品的需求,但数据不确定.
- 有DOAC逆转剂可用于血液管理;正在开发快速评估方法.
结论:
- 由于受伤前的DOAC使用,不建议在近接大腿骨骨折的手术中进行例行延迟.
- 个体化评估是关键,特别是在患有出血风险的患者中.
- 应该把重点放在安全的术后管理上,而不是自动推迟手术.
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