[在接受DOAC治疗的患者中,在系统性血栓溶解之前使用血栓显微镜 - 病例系列]
Lóránd Hegyi1, Péter Klivényi1,2, Alex Beke1
1Szegedi Tudományegyetem, Szent-Györgyi Albert Orvostudományi Kar, Szent-Györgyi Albert Klinikai Központ, Neurológiai Klinika, Szeged.
概括
直接口服抗凝剂 (DOAC) 复杂化了急性缺血性中风的治疗. 像RVV和ECA这样的粘弹性测试可以快速评估DOAC的效果,有助于在未知抗凝药史的患者中进行血栓溶解的决定.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 血液学 血液学 血液学
背景情况:
- 直接口服抗凝剂 (DOAC) 的使用越来越多,这给急性缺血性中风管理带来了挑战.
- 血栓溶解在服用DOAC后48小时内是禁忌的,因此需要进行准确的合规性评估.
- 准确的患者使用DOAC的病史往往无法获得,这使治疗决策复杂化.
相关概念视频
Venous Thrombosis III: Interprofessional Care
22
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...
22
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
1.3K
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...
1.3K
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
44
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
44
Anticoagulant Drugs: Low-Molecular-Weight Heparins
911
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...
911
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
37
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...
37
Acute Coronary Syndrome III: Diagnostic Studies
23
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
23


