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用于预防和治疗血栓栓塞的抗凝血药物。

Anticoagulant Medications for the Prevention and Treatment of Thromboembolism.

作者信息

Brien Lori

机构信息

Lori Brien is Acute Care Nurse Practitioner, Cardiovascular and Thoracic Surgery, Virginia Hospital Center, Arlington, Virginia, and Assistant Program Director, School of Nursing and Health Studies, Adult Gerontology Acute Care Nurse Practitioner Program, Georgetown University, 3700 Reservoir Rd NW, Washington, DC 20057 (

出版信息

AACN Adv Crit Care. 2019 Summer;30(2):126-138. doi: 10.4037/aacnacc2019867.

Abstract

Venous thromboembolism is a preventable medical condition associated with significant morbidity and mortality. It can lead to deep vein thrombosis, pulmonary embolism, and stroke. Thrombi develop when intravascular conditions promote activation of the coagulation system or when there is an imbalance between endogenous anticoagulants and procoagulants. Such conditions include vascular injury, inflammation, venous stasis, and hypercoagulable states. Anticoagulant medications are indicated for the prevention and treatment of venous thromboembolism. They exert their effect on clotting factors to prevent the formation of thrombi or the propagation of an existing clot. Historically, anticoagulants were limited to heparins and vitamin K antagonists. Over the past 15 years, however, several new anticoagulant medications have been introduced. This article describes commonly prescribed and newer anticoagulants available to health care professionals, including their mechanism of action, therapeutic use, unique characteristics, and available reversal agents in the event of life-threatening bleeding.

摘要

静脉血栓栓塞是一种可预防的医学病症,与显著的发病率和死亡率相关。它可导致深静脉血栓形成、肺栓塞和中风。当血管内状况促进凝血系统激活或内源性抗凝剂与促凝剂之间出现失衡时,血栓就会形成。此类状况包括血管损伤、炎症、静脉淤滞和高凝状态。抗凝药物适用于静脉血栓栓塞的预防和治疗。它们对凝血因子发挥作用,以防止血栓形成或现有血栓的扩展。历史上,抗凝剂仅限于肝素和维生素K拮抗剂。然而,在过去15年中,已引入了几种新型抗凝药物。本文介绍了医疗保健专业人员可使用的常用和新型抗凝剂,包括它们的作用机制、治疗用途、独特特性以及在发生危及生命的出血时可用的逆转剂。

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