在外科手术期间的血栓预防中,XA因子抑制剂和低分子量肝素:网络元分析
Vijeta Bajpai1, Tejas Patel2, Priyanka Dwivedi1
1Department of Anaesthesiology, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, 273008, India.
Cardiovascular & hematological agents in medicinal chemistry
|October 3, 2024
概括
里瓦罗克萨班,芬达帕鲁努克斯,埃多克萨班和贝米帕林在进行大手术后预防静脉血栓塞栓症 (VTE) 的疗效优于埃诺克萨帕林. 然而, fondaparinux 和贝米巴林携带更高的重大出血风险.
科学领域:
- 药理学 药理学是指药理学的学科.
- 医疗干预 医疗干预
- 临床试验 临床试验
背景情况:
- 静脉血栓栓塞 (VTE) 预防对于预防深静脉血栓塞 (DVT) 和肺栓塞 (PE) 非常重要.
- 这个网络的元分析评估了选择性XA因子抑制剂和低分子量肝素 (LMWHs) 在重大手术中用于外科手术期间的血栓预防.
研究的目的:
- 在选择性XA抑制剂和LMWH中确定最有效的血栓预防药物.
- 为了比较各种抗凝剂在主要腹部,骨盆,腰椎和下肢手术中的疗效和安全性.
主要方法:
- 一个系统的文献搜索确定了随机对照试验 (RCT),比较抗凝剂和安慰剂.
- 贝叶斯网络元分析评估了DVT,VTE,主要VTE和出血的风险.
- 累积排名曲线下的表面 (SUCRA) 排名干预措施.
主要成果:
- 芬达巴努克斯和里瓦罗克萨班显著降低了 DVT 风险,而埃诺沙巴林则显著降低了风险.
- 贝米帕林,埃多克萨班,芬达帕鲁努克斯和里瓦罗克萨班与埃诺克萨帕林相比降低了静脉瘤风险.
- 里瓦罗克萨班显著降低了主要VTE风险;芬达帕鲁努克斯和贝米巴林有更高的重大出血风险.
结论:
- 里瓦罗克萨班,芬达帕鲁努克斯,埃多克萨班和贝米帕林在重大手术中对外科手术期间的血栓预防更有效.
- 与其他评估的药物相比,芬达巴努克斯和贝米巴林存在较大的出血风险.
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