在急性胰腺炎中治疗状静脉血栓症:全球DELPHI共识研究
Michael Scott1, Mudassar Ghazanfar2, John Windsor3
1General Surgery ST1 Trainee, Paediatric Surgery, Royal Hospital for Children and Young People, Edinburgh, EH16 4TJ, UK.
在急性胰腺炎中,脊柱静脉血栓形成 (SpVT) 是常见的. 专家们就门脉和上层中枢静脉血栓症的抗凝药达成共识,但不包括脉血栓症,强调需要进一步的试验.
科学领域:
- 胃肠病学和肝病学 胃肠学和肝病学
- 血管外科 血管外科
- 临床血栓形成 临床血栓形成
背景情况:
- 脊柱静脉血栓症 (SpVT) 复杂化了17-23%的急性胰腺炎病例.
- 潜在的严重后果包括肝脏和肠道缺血症.
- 由于出血风险,抗凝药管理存在争议.
研究的目的:
- 确定专家对急性胰腺炎的预后,诊断,管理和SVPT的结果的共识.
- 为临床实践提供信息,并通过Delphi过程指导未来的研究.
主要方法:
- 一个三轮的Delphi过程,涉及173名临床医生,在SpVT和急性胰腺炎方面有经验.
- 在2022年4月至2023年4月期间,88个陈述使用四点的利克特级别进行了排名.
主要成果:
- 强烈的共识赞成门静脉 (89.1%) 和上层中枢静脉 (SMV) 血栓形成 (90.9%) 的抗凝药.
- 对于治疗静脉血栓 (47.3%) 没有达成共识.
- 放射学分辨率被拒绝作为最终的抗凝结药物终点;死亡,出血,缺血和入院时间是关键结果.
结论:
- 显著的专家共识支持门和SMV血栓形成的抗凝药,特别是完全封闭的.
- 随机对照试验是必要的,以建立对SpVT的最终管理准则.
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