低剂量阿司匹林与高剂量阿司匹林用于全关节整形术后静脉血栓栓塞预防:系统性审查和元分析
Peyman Mirghaderi1, Mohammad-Taha Pahlevan-Fallahy2,3, Payman Rahimzadeh1
1Surgical Research Society (SRS), Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Journal of orthopaedic surgery and research
|December 20, 2024
概括
低剂量阿司匹林 (162毫克) 与高剂量阿司匹林 (650毫克) 相比,在全关节整形术 (TJA) 后预防静脉血栓塞栓症 (VTE) 的疗效相似,关节感染风险更低.
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.
- 基于证据的医学基于证据的医学.
背景情况:
- 阿司匹林的副作用取决于剂量,这引发了关于其在全关节形术 (TJA) 后用于预防静脉血栓栓塞 (VTE) 的争论.
- 目前的研究缺乏低剂量 (LD) 和高剂量 (HD) 阿司匹林之间的确定的比较,用于TJA后的VTE预防.
研究的目的:
- 为了比较LD阿司匹林 (162毫克/天) 与HD阿司匹林 (650毫克/天) 在TJA后的VTE预防中的疗效和并发症率.
- 评估阿司匹林剂量对深静脉血栓 (DVT),肺栓塞 (PE),周围假肢关节感染 (PJI) 和胃肠道出血 (GIB) 的影响.
主要方法:
- 对14项符合条件的研究进行了系统的分析,其中包括43518名LD组患者和62645名HD组患者的数据.
- 从开始到2024年9月,搜索了四个主要数据库,用于比较TJA患者阿司匹林剂量的研究.
- 在森林地块图中使用概率比率 (ORs) 进行了VTE和并发症率的比较.
主要成果:
- 与LD组相比,HD阿司匹林组的整体VTE发病率明显高于HD阿司匹林组 (OR:1.53,P=0.002).
- 高剂量阿司匹林与显著更高的周围假肢关节感染 (PJI) 率相关 (OR:2.68,P=0.001).
- 深静脉血栓 (DVT),肺栓塞 (PE) 和胃肠道出血 (GIB) 的发生率在LD和HD阿司匹林组之间没有显著差异.
结论:
- 低剂量阿司匹林 (162毫克/天) 似乎是TJA后VTE化疗预防的可行和潜在的更安全的选择.
- LD阿司匹林可能提供与HD阿司匹林相似的VTE预防效果,降低了PJI的风险.
相关概念视频
Anticoagulant Drugs: Low-Molecular-Weight Heparins
2.6K
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
2.6K
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
2.8K
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
2.8K
Venous Thrombosis I: Introduction
834
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
834
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
470
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
470
Venous Thrombosis III: Interprofessional Care
482
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
482
Venous Thrombosis IV: Nursing Management
418
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
418


