目的:系统评价骨科大手术后静脉血栓栓塞症(Venous thromboembolism,VTE)预防的国内外相关指南,总结指南中对新型口服抗凝药(Novel oral anticoagulants,NOAC)的推荐意见,为指南的修订和临床治疗提供参考依据。方法:检索国内外相关数据...目的:系统评价骨科大手术后静脉血栓栓塞症(Venous thromboembolism,VTE)预防的国内外相关指南,总结指南中对新型口服抗凝药(Novel oral anticoagulants,NOAC)的推荐意见,为指南的修订和临床治疗提供参考依据。方法:检索国内外相关数据库及专业网站,总结骨科大手术后VTE预防的相关指南,用AGREE II指南质量评价工具进行质量评价,并总结NOAC在指南中的推荐。结果:共检索筛选出国内外相关指南7个,经质量评价后,推荐使用的指南有4个,建议修订后使用的指南有1个,不推荐使用的指南有2个。结论:推荐参考的指南有英国国家卫生和临床技术优化研究所(National institute for health and care excellence,NICE)发表的3个指南和美国骨科医师学会(American academy of orthopaedic surgeons,AAOS)指南。用于骨科大手术后VTE预防的NOAC有达比加群酯、利伐沙班和阿哌沙班,其在有效性和安全性方面优于传统的抗凝药物。展开更多
目的:评价新型口服抗凝药(NOACs)治疗房颤合并糖尿病有效性和安全性。方法:检索中英文数据库从建库至2016年8月新型口服抗凝药治疗房颤合并糖尿病随机对照试验研究,筛选合格研究。筛选文献、提取资料和评价纳入研究的偏倚风险后,采用Rev...目的:评价新型口服抗凝药(NOACs)治疗房颤合并糖尿病有效性和安全性。方法:检索中英文数据库从建库至2016年8月新型口服抗凝药治疗房颤合并糖尿病随机对照试验研究,筛选合格研究。筛选文献、提取资料和评价纳入研究的偏倚风险后,采用Rev Man 5.3软件进行Meta分析。结果:符合纳入标准的文献共4篇,meta分析结果显示,与华法林组相比,NOACS可显著降低全因病死率、卒中和体循环栓塞率及颅内出血率,而大出血率则与华法林相当。结论:NOACs治疗房颤合并糖尿病有效性和安全性方面不劣于华法林,但由于大出血率相当,故房颤合并糖尿病患者在使用NOACs时有必要进行监测,以减少大出血等不良反应的发生。展开更多
Thrombotic complications appear to be a major predictor of death in COVID-19 patients,and multiple studies have shown that anticoagulants can help to improve the outcome.The Food and Drug Administration’s acceptance ...Thrombotic complications appear to be a major predictor of death in COVID-19 patients,and multiple studies have shown that anticoagulants can help to improve the outcome.The Food and Drug Administration’s acceptance of non-vitamin K antagonist oral anticoagulants(NOACs)has sparked much excitement about their potential as a replacement for existing oral anticoagulants.NOACs target a single clotting factor,often activated factor X or thrombin,and involve the coagulation factor Xa inhibitors including apixaban,edoxaban,and rivaroxaban,and the thrombin inhibitor dabigatran.COVID-19 is an infectious disease that causes thrombotic events by inducing a pro-inflammatory and prothrombotic condition.This article provides a comprehensive overview of the mechanism behind enhanced thrombogenicity accompanying COVID-19,the clinical range of NOACs,and the role of NOACs in treatment of COVID-19 based on recent investigations and clinical trials.展开更多
Healthcare practitioners have many anticoagulant options for treating various disease states pertaining to blood clots and blood clot formation. Each anticoagulant has pros and cons and the decision of which pharmacol...Healthcare practitioners have many anticoagulant options for treating various disease states pertaining to blood clots and blood clot formation. Each anticoagulant has pros and cons and the decision of which pharmacological agent to use can be confusing and difficult. In years past, Vitamin K antagonists have been the standard of care when treating specific disease states such as atrial fibrillation and venous thromboembolism based on habit and cost of care. The emergence of newer anticoagulants should be considered the new standard of care based on the evidence presented over the last several years.展开更多
Understanding and managing the bleeding＇s causes is essential for a good surgical practice in general. In fact, it is crucial to know how to manage and control this problem （sometimes simply annoying, but that may b...Understanding and managing the bleeding＇s causes is essential for a good surgical practice in general. In fact, it is crucial to know how to manage and control this problem （sometimes simply annoying, but that may be able to cause even dangerous consequences） with a comprehensive and multidisciplinary approach, trying to use all the means is available today. The goal of this paper is to describe, even through a brief review of the literature--the State of Art about the bleeding control in oral surgery, the proper use of surgical devices and the NOACs （new oral anticoagulants） appearance.展开更多
文摘目的:系统评价骨科大手术后静脉血栓栓塞症(Venous thromboembolism,VTE)预防的国内外相关指南,总结指南中对新型口服抗凝药(Novel oral anticoagulants,NOAC)的推荐意见,为指南的修订和临床治疗提供参考依据。方法:检索国内外相关数据库及专业网站,总结骨科大手术后VTE预防的相关指南,用AGREE II指南质量评价工具进行质量评价,并总结NOAC在指南中的推荐。结果:共检索筛选出国内外相关指南7个,经质量评价后,推荐使用的指南有4个,建议修订后使用的指南有1个,不推荐使用的指南有2个。结论:推荐参考的指南有英国国家卫生和临床技术优化研究所(National institute for health and care excellence,NICE)发表的3个指南和美国骨科医师学会(American academy of orthopaedic surgeons,AAOS)指南。用于骨科大手术后VTE预防的NOAC有达比加群酯、利伐沙班和阿哌沙班,其在有效性和安全性方面优于传统的抗凝药物。
文摘目的:评价新型口服抗凝药(NOACs)治疗房颤合并糖尿病有效性和安全性。方法:检索中英文数据库从建库至2016年8月新型口服抗凝药治疗房颤合并糖尿病随机对照试验研究,筛选合格研究。筛选文献、提取资料和评价纳入研究的偏倚风险后,采用Rev Man 5.3软件进行Meta分析。结果:符合纳入标准的文献共4篇,meta分析结果显示,与华法林组相比,NOACS可显著降低全因病死率、卒中和体循环栓塞率及颅内出血率,而大出血率则与华法林相当。结论:NOACs治疗房颤合并糖尿病有效性和安全性方面不劣于华法林,但由于大出血率相当,故房颤合并糖尿病患者在使用NOACs时有必要进行监测,以减少大出血等不良反应的发生。
文摘Thrombotic complications appear to be a major predictor of death in COVID-19 patients,and multiple studies have shown that anticoagulants can help to improve the outcome.The Food and Drug Administration’s acceptance of non-vitamin K antagonist oral anticoagulants(NOACs)has sparked much excitement about their potential as a replacement for existing oral anticoagulants.NOACs target a single clotting factor,often activated factor X or thrombin,and involve the coagulation factor Xa inhibitors including apixaban,edoxaban,and rivaroxaban,and the thrombin inhibitor dabigatran.COVID-19 is an infectious disease that causes thrombotic events by inducing a pro-inflammatory and prothrombotic condition.This article provides a comprehensive overview of the mechanism behind enhanced thrombogenicity accompanying COVID-19,the clinical range of NOACs,and the role of NOACs in treatment of COVID-19 based on recent investigations and clinical trials.
文摘Healthcare practitioners have many anticoagulant options for treating various disease states pertaining to blood clots and blood clot formation. Each anticoagulant has pros and cons and the decision of which pharmacological agent to use can be confusing and difficult. In years past, Vitamin K antagonists have been the standard of care when treating specific disease states such as atrial fibrillation and venous thromboembolism based on habit and cost of care. The emergence of newer anticoagulants should be considered the new standard of care based on the evidence presented over the last several years.
文摘Understanding and managing the bleeding＇s causes is essential for a good surgical practice in general. In fact, it is crucial to know how to manage and control this problem （sometimes simply annoying, but that may be able to cause even dangerous consequences） with a comprehensive and multidisciplinary approach, trying to use all the means is available today. The goal of this paper is to describe, even through a brief review of the literature--the State of Art about the bleeding control in oral surgery, the proper use of surgical devices and the NOACs （new oral anticoagulants） appearance.
