对于接受口服抗凝治疗的患者,出血管理需要风险分层、预防策略和适当的恢复时机,如本实用综述所述。
综述
This review provides practical, patient-centered flowcharts for the acute management of bleeding and the safe resumption of oral anticoagulants in clinical practice.
出血是抗凝治疗中常见且经常严重的并发症。在常见心血管疾病(如房颤)中使用口服抗凝剂以预防血栓事件,使患者面临更高的出血风险,而这种风险与发病率和死亡率相关。出血的后果远远超出急性事件,影响治疗依从性、长期管理决策,并在抗凝停止时增加缺血事件的风险。优化血栓风险和出血风险之间的平衡需要在风险分层、预防策略、急性管理及止血后抗凝恢复的适当时机等方面的专业知识。本文回顾了接受口服抗凝治疗患者出血的流行病学和临床影响,并提供了当代以患者为中心的急性管理和安全恢复治疗的流程图。未来的努力应集中于完善风险预测、个性化抗凝方案,并改善获得靶向逆转剂的机会,以进一步改善患者结果。
Galli et al. (Thu,) conducted a review in Bleeding complications of oral anticoagulant therapy. Management of bleeding and resumption of anticoagulation was evaluated. Management of bleeding in patients on oral anticoagulants requires risk stratification, preventive strategies, and appropriate timing of resumption, as outlined in this practical review.