短肠综合征中的抗凝血和抗血小板治疗:系统性审查
Carolyn Mercer1, Anna Crawford1, Susan Shapiro2,3
1Translational Gastroenterology and Liver Unit, NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom.
Intestinal Failure (New York, N.Y.)
|February 6, 2026
概括
用华法林进行的抗凝血疗法对短肠综合征 (SBS) 有效. 虽然直接口服抗凝剂如利瓦洛克萨班和阿皮克萨班显示出希望,但对于SBS患者的抗血小板剂需要更多的研究.
科学领域:
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 短肠综合症 (SBS) 由于改变了解剖学和吸收,对药物治疗提出了挑战.
- 在SBS患者中,对于潜在的疾病或腹腔支并发症,通常需要抗凝药.
研究的目的:
- 对短肠综合征患者抗凝血剂和抗血小板剂的疗效和安全性进行文献审查.
主要方法:
- 在主要数据库 (MEDLINE,EMBASE,Cochrane图书馆) 进行了系统的文献搜索,直到2024年2月.
- 包括专注于短肠综合征,抗凝固剂和抗血小板剂的研究.
- 适用资格标准选了725篇文章,其中24篇符合要求,主要是案例报告和系列.
主要成果:
- 华法林在SBS患者中表现出有效的抗凝作用,即使肠道长度只有12厘米.
- 直接口服抗凝剂 (DOAC),如利瓦洛克萨班和阿皮克萨班在SBS中达到目标度,而利瓦洛克萨班在30厘米肠道的患者中进行了研究.
- 达比加特兰显示不可靠的度达到,对抗血小板剂的数据是最小的,缺乏长期结果报告.
结论:
- 华法林是短肠综合征的有效抗凝剂,得到现有文献的支持.
- 里瓦罗克萨班和阿皮克萨班在SBS中似乎被充分吸收,但需要进一步的长期结果研究.
- 目前没有足够的证据来推针对短肠综合征的特定抗血小板疗法.
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