文献检索文档翻译深度研究
Suppr Zotero 插件Zotero 插件
邀请有礼套餐&价格历史记录

新学期,新优惠

限时优惠:9月1日-9月22日

30天高级会员仅需29元

1天体验卡首发特惠仅需5.99元

了解详情
不再提醒
插件&应用
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
高级版
套餐订阅购买积分包
AI 工具
文献检索文档翻译深度研究
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利:CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2025

美国血液学会 2018 年静脉血栓栓塞症管理指南:抗凝治疗的最佳管理。

American Society of Hematology 2018 guidelines for management of venous thromboembolism: optimal management of anticoagulation therapy.

机构信息

Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT.

Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.

出版信息

Blood Adv. 2018 Nov 27;2(22):3257-3291. doi: 10.1182/bloodadvances.2018024893.


DOI:10.1182/bloodadvances.2018024893
PMID:30482765
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6258922/
Abstract

BACKGROUND: Clinicians confront numerous practical issues in optimizing the use of anticoagulants to treat venous thromboembolism (VTE). OBJECTIVE: These evidence-based guidelines of the American Society of Hematology (ASH) are intended to support patients, clinicians and other health care professionals in their decisions about the use of anticoagulants in the management of VTE. These guidelines assume the choice of anticoagulant has already been made. METHODS: ASH formed a multidisciplinary guideline panel balanced to minimize potential bias from conflicts of interest. The McMaster University GRADE Centre supported the guideline development process, including updating or performing systematic evidence reviews. The panel prioritized clinical questions and outcomes according to their importance for clinicians and patients. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess evidence and make recommendations, which were subject to public comment. RESULTS: The panel agreed on 25 recommendations and 2 good practice statements to optimize management of patients receiving anticoagulants. CONCLUSIONS: Strong recommendations included using patient self-management of international normalized ratio (INR) with home point-of-care INR monitoring for vitamin K antagonist therapy and against using periprocedural low-molecular-weight heparin (LMWH) bridging therapy. Conditional recommendations included basing treatment dosing of LMWH on actual body weight, not using anti-factor Xa monitoring to guide LMWH dosing, using specialized anticoagulation management services, and resuming anticoagulation after episodes of life-threatening bleeding.

摘要

背景:临床医生在优化抗凝剂的使用以治疗静脉血栓栓塞症(VTE)时会面临许多实际问题。

目的:这些美国血液学会(ASH)的循证指南旨在帮助患者、临床医生和其他医疗保健专业人员在 VTE 管理中使用抗凝剂的决策。这些指南假设已经选择了抗凝剂。

方法:ASH 成立了一个多学科指南小组,以平衡最小化潜在的利益冲突偏见。麦克马斯特大学 GRADE 中心支持指南制定过程,包括更新或进行系统的证据审查。小组根据对临床医生和患者的重要性对临床问题和结果进行了优先级排序。使用 Grading of Recommendations Assessment, Development and Evaluation(GRADE)方法评估证据并提出建议,这些建议将接受公众意见。

结果:小组就优化接受抗凝剂治疗的患者管理达成了 25 项建议和 2 项良好实践声明。

结论:强烈建议包括使用患者自我管理国际标准化比值(INR)和家庭即时检测 INR 监测来进行维生素 K 拮抗剂治疗,并反对使用围手术期低分子量肝素(LMWH)桥接治疗。有条件的建议包括根据实际体重确定 LMWH 的治疗剂量、不使用抗因子 Xa 监测来指导 LMWH 剂量、使用专门的抗凝管理服务,以及在危及生命的出血发作后恢复抗凝治疗。

相似文献

[1]
American Society of Hematology 2018 guidelines for management of venous thromboembolism: optimal management of anticoagulation therapy.

Blood Adv. 2018-11-27

[2]
American Society of Hematology 2018 guidelines for management of venous thromboembolism: venous thromboembolism in the context of pregnancy.

Blood Adv. 2018-11-27

[3]
American Society of Hematology 2018 guidelines for management of venous thromboembolism: prophylaxis for hospitalized and nonhospitalized medical patients.

Blood Adv. 2018-11-27

[4]
American Society of Hematology 2018 guidelines for management of venous thromboembolism: heparin-induced thrombocytopenia.

Blood Adv. 2018-11-27

[5]
American Society of Hematology 2020 guidelines for management of venous thromboembolism: treatment of deep vein thrombosis and pulmonary embolism.

Blood Adv. 2020-10-13

[6]
American Society of Hematology 2018 Guidelines for management of venous thromboembolism: treatment of pediatric venous thromboembolism.

Blood Adv. 2018-11-27

[7]
American Society of Hematology 2021 guidelines for management of venous thromboembolism: prevention and treatment in patients with cancer.

Blood Adv. 2021-2-23

[8]
American Society of Hematology 2021 guidelines on the use of anticoagulation for thromboprophylaxis in patients with COVID-19.

Blood Adv. 2021-2-9

[9]
American Society of Hematology living guidelines on the use of anticoagulation for thromboprophylaxis in patients with COVID-19: January 2022 update on the use of therapeutic-intensity anticoagulation in acutely ill patients.

Blood Adv. 2022-9-13

[10]
Venous thromboembolism, thrombophilia, antithrombotic therapy, and pregnancy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition).

Chest. 2008-6

引用本文的文献

[1]
Overcoming Barriers to Warfarin Patient Self-Management (PSM) in the US Healthcare System: Implementation Trial Study Protocol.

medRxiv. 2025-8-21

[2]
Interventional Procedures in Deep Venous Thrombosis Treatment: A Review of Techniques, Outcomes, and Patient Selection.

Medicina (Kaunas). 2025-8-18

[3]
A qualitative study exploring patient experiences and opinions of warfarin patient self-management in the US healthcare system.

J Am Coll Clin Pharm. 2024-3

[4]
A qualitative study evaluating provider perceptions of implementing warfarin patient self-management in the United States healthcare system.

J Am Coll Clin Pharm. 2023-12

[5]
The clot cases conference: a proposed model to enhance multidisciplinary thrombosis care.

J Thromb Thrombolysis. 2025-7-18

[6]
Effectiveness and safety of concomitant use of direct oral anticoagulants and antiarrhythmic drugs: a systematic review of observational studies.

Eur J Clin Pharmacol. 2025-7-16

[7]
Identifying and addressing underuse in hematologic care through systems-based hematology.

Res Pract Thromb Haemost. 2025-5-8

[8]
Oral Anticoagulants in Women: What's the Difference? A Narrative Review.

Clin Appl Thromb Hemost. 2025

[9]
A retrospective cohort analysis of plasma TAT level trends and adverse pregnancy outcomes in early pregnancy patients with newly diagnosed VTE.

Thromb J. 2025-5-15

[10]
Left atrial appendage occlusion in patients with cancer.

J Thromb Thrombolysis. 2025-4-5

本文引用的文献

[1]
Prothrombin Complex Concentrate for Major Bleeding on Factor Xa Inhibitors: A Prospective Cohort Study.

Thromb Haemost. 2018-3-21

[2]
Association of prothrombin complex concentrate administration and hematoma enlargement in non-vitamin K antagonist oral anticoagulant-related intracerebral hemorrhage.

Ann Neurol. 2018-1

[3]
CDC Grand Rounds: Improving Medication Adherence for Chronic Disease Management - Innovations and Opportunities.

MMWR Morb Mortal Wkly Rep. 2017-11-17

[4]
Cost-effectiveness of the pharmacist-assisted warfarin monitoring program at a Medical Center in Taiwan.

Int J Qual Health Care. 2017-10-1

[5]
Management of rivaroxaban- or apixaban-associated major bleeding with prothrombin complex concentrates: a cohort study.

Blood. 2017-8-23

[6]
Idarucizumab for Dabigatran Reversal - Full Cohort Analysis.

N Engl J Med. 2017-7-11

[7]
Efficacy and Safety of Rivaroxaban Versus Warfarin in Patients Taking Nondihydropyridine Calcium Channel Blockers for Atrial Fibrillation (from the ROCKET AF Trial).

Am J Cardiol. 2017-8-15

[8]
Prothrombin complex concentrate administration for bleeding associated with non-vitamin K antagonist oral anticoagulants: The SAMURAI-NVAF study.

J Neurol Sci. 2017-4-15

[9]
Outcomes Associated With Resuming Warfarin Treatment After Hemorrhagic Stroke or Traumatic Intracranial Hemorrhage in Patients With Atrial Fibrillation.

JAMA Intern Med. 2017-4-1

[10]
Optimal timing of vitamin K antagonist resumption after upper gastrointestinal bleeding. A risk modelling analysis.

Thromb Haemost. 2017-2-28

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

推荐工具

医学文档翻译智能文献检索