在深静脉血栓症的诊断工作期间,实证抗凝药的临床使用和安全性
Hodo Mohamad1,2, Camilla Tøvik Jørgensen2,3, Waleed Ghanima1,2
1Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
Hematology (Amsterdam, Netherlands)
|October 21, 2025
概括
在初级保健中,在疑似深静脉血栓症 (DVT) 病例中,使用低分子量肝素 (LMWH) 的实证抗凝药似乎是安全的,尽管大多数患者接受了亚治疗剂量. 出血并发症是最小的,支持其在最终诊断之前使用.
科学领域:
- 紧急医疗 紧急医疗
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 以前的研究表明,经验性抗凝剂在疑似深静脉血栓症 (DVT) 时是安全的.
- 然而,其在初级保健环境中的安全性仍未得到充分研究.
- 这项研究解决了了解初级保健中的实证抗凝安全性的差距.
研究的目的:
- 在初级保健中评估低分子量肝素 (LMWH) 在怀疑DVT的临床使用和安全性.
- 评估经验性LMWH启动后发生的出血事件和肺栓塞 (PE) 的发展.
- 在这种环境中分析LMWH剂量模式 (治疗与次治疗).
主要方法:
- 在2015年2月至2018年11月期间评估疑似DVT的患者的回顾性分析.
- 纳入标准:挪威奥斯特福德医院急诊室的患者.
- 安全性评估包括重大和临床相关的非重大出血 (CRNMB) 事件和PE在48小时后的PE发展.
主要成果:
- 在1653名患者中,有328名患者 (19.8%) 接受了经验性LMWH.
- 大多数患者 (70.7%) 接受了亚治疗剂量;埃诺沙巴林是最常见的药物 (94.2%).
- 没有发生重大出血事件或死亡;两名患者 (0.6%) 患有CRNMB事件. 没有发现新的肺栓塞 (PE) 病例.
结论:
- 在初级保健中对疑似DVT病例的实证LMWH管理显示出出血并发症的低率.
- 这项研究表明,经验性抗凝剂通常是安全的,即使经常使用亚治疗剂量.
- 处方模式往往忽视了测试前的概率得分和出血风险评估.
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