探索DOACs的经营性使用,脱离常规道路
Fabiana Lucà1, Fabrizio Oliva2, Simona Giubilato3
1Cardiology Department, Grande Ospedale Metropolitano, GOM, AO Bianchi Melacrino Morelli, 89124 Reggio Calabria, Italy.
Journal of clinical medicine
|June 19, 2024
概括
直接口服抗凝剂 (DOAC) 越来越多地使用,但在手术期间管理它们需要仔细规划. 本综述为在DOAC治疗期间接受手术的患者提供了平衡出血风险和凝块预防的指导.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 在外科手术期间的医学.
背景情况:
- 直接口服抗凝剂 (DOAC) 在很大程度上取代了维生素K对抗剂 (VKA) 由于提高了有效性,安全性和方便性.
- 增加的DOAC利用在需要手术或干预手术的患者管理方面带来了挑战.
- 对于DOAC使用者来说,外科手术期间的抗凝管理是一个日益严重的临床问题.
研究的目的:
- 为临床医生提供关于在外科手术期间直接口服抗凝剂 (DOAC) 管理的实用指南.
- 解决有争议的问题,并提供最佳患者护理策略.
- 为了指导医生在关于停止和恢复DOAC的决策.
主要方法:
- 这篇叙事综述综合了当前的文献和临床指导方针.
- 它的重点是评估患者特异性因素和程序风险.
- 在外科手术期间的管理中强调多学科的方法.
主要成果:
- 最佳的术后管理需要对患者的因素 (年龄,中风风险,出血史,/肝功能,药物) 和手术考虑进行全面评估.
- 一些程序可能允许最小或不间断的DOAC策略,而另一些程序则需要暂时停止.
- 个性化策略对于平衡血栓和出血风险至关重要.
结论:
- 对于DOAC患者而言,有效的术后抗凝药需要仔细,个性化规划.
- 多学科的团队方法对于成功的管理至关重要.
- 本综述旨在为医生提供必要的知识,以应对这些复杂的临床情景.
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