Kelm C, Engels K
Chirurgie 1, Klinik für Allgemein-, Visceral- und spezielle Visceralchirurgie, Klinikum Lüdenscheid, Paulmannshöherstr.14, 58515, Lüdenscheid, Deutschland.
Med Klin Intensivmed Notfmed. 2017 Mar;112(2):125-128. doi: 10.1007/s00063-016-0244-y. Epub 2017 Jan 12.
Regarding thromboembolic events, non-vitamin K antagonists, so-called new oral anticoagulative agents (NOACs), have widely enlarged prophylaxis and therapy. In contrast to vitamin K antagonists they can be administered in a definite dose and do not need any regular control of coagulation parameters. Thus being simple in handling, these drugs have become enormously attractive for both patient and physician.In spite of all their advantages NOACs have to be considered carefully. They have a significant disadvantage: the plasma concentration is not detectable by a simple blood test, nor is there any antidote available. As a consequence the bleeding risk remains unknown.In this review we focus on two different settings in routine surgical work: the preoperative management of patients undergoing elective surgery differs significantly from that needed in urgent surgery.
关于血栓栓塞事件，非维生素K拮抗剂，即所谓的新型口服抗凝剂（NOACs），已广泛扩大了预防和治疗范围。与维生素K拮抗剂相比，它们可以以确定的剂量给药，并且不需要定期监测凝血参数。由于操作简单，这些药物对患者和医生都极具吸引力。尽管它们有诸多优点，但仍需谨慎考虑使用NOACs。它们有一个显著的缺点：无法通过简单的血液检测来测定血浆浓度，也没有可用的解毒剂。因此，出血风险仍然未知。在本综述中，我们关注常规外科手术中的两种不同情况：择期手术患者的术前管理与急诊手术所需的管理有显著差异。
