静脉血栓栓塞的十年趋势 在高容量关节塑造中心的静脉血栓栓塞预防
Juan D Lizcano1, Matthew B Sherman, Saad Tarabichi
1From the Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, PA (Lizcano, Sherman, Tarabichi, Baker, and Reddy), and the Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY (Austin).
The Journal of the American Academy of Orthopaedic Surgeons
|October 28, 2024
概括
静脉血栓塞栓症预防在全关节整形术中已经从华法林和未分离的肝素转向阿司匹林和Xa因子抑制剂. 这一转变与过去十年中VTE率大幅下降相吻合.
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.
- 血栓形成的研究研究
背景情况:
- 静脉血栓塞栓症 (VTE) 预防在全关节整形术 (TJA) 后是标准的.
- 根据文献和临床指导方针,用于静脉瘤预防的药物治疗模式不断发展.
- 分析机构药物治疗趋势对于了解VTE预防策略至关重要.
研究的目的:
- 分析VTE预防药物的变化模式在一个机构10年的时间.
- 为了将药物转移与TJA后的VTE发病率相关联.
- 评估不断发展的静脉瘤预防策略的有效性.
主要方法:
- 从2012年至2022年接受初级TJA的25095名患者的回顾性分析.
- 静脉瘤预防药物的分类,包括阿司匹林,华法林,未分离肝素 (UFH),低分子量肝素 (LMWH),Xa因子抑制剂 (FXa) 等.
- 计算和分析症状性静脉动脉栓塞率 (深静脉血栓,肺栓塞).
主要成果:
- 总体VTE率从2012年的1.1%下降到2022年的0.2%,但波动.
- 药物使用的显著转变:阿司匹林从52.1%增加到83.3%,华法林从30.7%减少到0.3%,FXa抑制剂从0%增加到10.4%,UFH从16.2%减少到1.8%.
- 低剂量阿司匹林 (81毫克) 成为主导的药物,而胺酸 (TXA) 的使用率从30.8%上升到84.9%.
结论:
- 该机构从华法林,UFH和高剂量阿司匹林转向低剂量阿司匹林和FXa抑制剂进行静脉突发动脉瘤预防.
- 这种药物转换与可接受的低深静脉血栓形成和降低肺栓塞率有关.
- 不断发展的VTE预防策略在减少TJA后的血栓事件方面表现出有效性.
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