德尔菲小组就内源库辛综合征静脉血栓栓塞的血栓预防建议达成共识:一个立场声明
Kristina Isand1,2,3, Hiroshi Arima4, Jerome Bertherat5
1Institute of Biomedicine and Translational Medicine, University of Tartu, Ülikooli 18, 50090 Tartu, Estonia.
European journal of endocrinology
|February 20, 2025
概括
在库辛综合征 (CS) 患者中制定了预防血栓 (静脉血栓栓塞) 的建议. 专家建议在诊断时开始进行血栓预防,并在治疗后继续进行,以获得更好的结果.
科学领域:
- 内分泌学 在内分泌学.
- 血液学 血液学 血液学
- 临床医学 临床医学
背景情况:
- 库辛综合征 (CS) 显著增加了由于高皮质醇症导致静脉血栓栓塞 (VTE) 的风险.
- 对于内源性CS患者,缺乏标准化的血栓预防指南.
- 需要专家的共识来解决VTE风险在这个人群.
研究的目的:
- 建立基于证据的推,对患有内源性库辛综合征的患者进行血栓预防.
- 提供关于VTE预防,术后管理和CS中VTE治疗的指导.
- 通过解决与高皮质醇相关的VTE风险,标准化护理并改善患者的治疗结果.
主要方法:
- 一个四轮的德尔菲方法,涉及来自11个国家的18名国际专家.
- 共识定义为对建议达成≥75%的共识.
- 建议分为血栓预防,术后管理和静脉瘤治疗.
主要成果:
- 建立了14个基于共识的建议.
- 在CS诊断时和缓解后3个月内推进行血栓预防.
- 低分子量肝素是首选的药物;建议进行外科手术期间的预防.
- 推延长静脉动脉突发症治疗预防3个月后Cushing的解决方案.
结论:
- 这些德尔菲共识建议旨在在库辛综合征中标准化血栓预防.
- 关于启动,延续和用于VTE预防和治疗的药物的指导.
- 需要进一步研究直接口服抗凝剂和轻度CS的管理.
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