在下肢骨折患者中预防VTE的NOAC:系统性审查和元分析
Bingbing Wu1,2, Lili Sun1,2, Wenying Wu1,2
1Department of Nursing, The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, 1th Shangcheng Avenue, Yiwu, Zhejiang Province, 322000, China.
Journal of orthopaedic surgery and research
|July 15, 2025
概括
新型口服抗凝剂 (NOAC) 与低分子量肝素 (LMWH) 相比,在下肢骨折的患者中,深静脉血栓形成 (DVT) 的风险降低. 然而,对于整体静脉血栓栓塞 (VTE),肺栓塞 (PE) 或重大出血事件,没有发现显著差异.
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.
- 血管医学 血管医学
背景情况:
- 新型口服抗凝剂 (NOAC) 越来越多地被处方给接受骨科手术的患者.
- 静脉血栓塞栓症 (VTE) 是患有下肢骨折的患者的重大风险.
研究的目的:
- 评估NOACs在预防下肢骨折患者的静脉瘤中的有效性和安全性.
- 在这个患者群体中,将NOAC与低分子量肝素 (LMWH) 进行比较.
主要方法:
- 进行了随机对照试验 (RCT) 的元分析.
- 在PubMed,Embase,Cochrane图书馆和Web of Science数据库中进行文献搜索,截至2024年11月27日.
- 使用Cochrane风险偏差工具2.0评估偏差风险;使用RevMan 5.4.1.1分析的数据.
主要成果:
- 包括5个RCT,共有4092名参与者.
- NOACs显著降低了深静脉血栓症 (DVT) 的发生率 (OR=0.48,P=0.04).
- 在VTE,肺栓塞 (PE) 或重大出血事件方面没有观察到显著差异.
结论:
- NOACs在降低下肢骨折患者的DVT风险方面显示出潜在的益处.
- 可能需要进一步的研究来确认在预防整体VTE和PE方面的有效性,并与LMWH相比充分评估安全性.
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