针对手术患者的抗凝血剂和抗血小板治疗的智能评估系统
Chien-Liang Fang1,2,3, Shan-Hua Liang2
1Division of Plastic and Reconstruction Surgery, Department of Surgery, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan.
International journal of surgery (London, England)
|November 17, 2025
概括
开发了一个智能系统来评估在接受抗凝剂或抗血小板治疗的患者的出血和血栓栓塞风险. 该系统成功地减少了术后不良事件,并简化了临床决策,以提高患者安全.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 医疗信息学 医疗信息学
背景情况:
- 对接受抗凝血剂或抗血小板治疗的患者进行手术前风险评估是复杂的,需要仔细平衡出血和血栓栓塞的风险.
- 目前关于药物停用,时间和恢复药物的决策过程存在临床挑战.
- 开发了一个创新的,集成的智能评估系统,以帮助临床医生最大限度地减少术后并发症.
研究的目的:
- 开发和评估一个智能系统,以优化在外科手术期间的抗凝剂和抗血小板治疗的管理.
- 为了减少术后缺血性中风,心肌梗塞和出血事件的发生率.
- 加强临床决策和简化外科手术期间药物管理的工作流程.
主要方法:
- 综合医院信息系统和国家医疗记录检索药物数据.
- 利用ICD-10编码来识别高风险的血栓塞栓症患者.
- 使用2018年欧洲心律协会指南评估出血风险.
- 自动推停止抗凝剂,取消时间 (基于肌素清除量和体重),并恢复治疗.
主要成果:
- 在系统实施之前 (2018年1月至2021年9月),五名患者经历了术后缺血性中风或心肌梗塞.
- 在实施后 (2021年10月至2025年3月),没有记录任何此类不良事件.
- 该系统将评估和教学时间的总和缩短了3.16分钟.
结论:
- 决策支持平台通过整合药物数据和执行实时计算来提高外科手术期间的安全性.
- 它为管理抗凝血剂,抗血小板剂和SGLT2抑制剂提供了结构化,自动化的指导.
- 该系统促进医疗保健专业人员之间的共识,并与临床工作流程保持一致.
相关概念视频
01:20Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
1.1K
Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
1.1K
01:29Venous Thrombosis III: Interprofessional Care
268
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...
268
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
1.6K
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...
1.6K
01:30Venous Thrombosis IV: Nursing Management
188
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
188