减肥手术会降低直接口服抗凝剂（DOACs）的疗效。
Bariatric Surgery can Lower the Efficacy of DOACs.
作者信息
Bitar Zouheir Ibrahim, Maadarani Ossama Sajeh, Mohsen Mohamed Jaber, Alkazemi Nawal Usamah
机构信息
Critical Care Unit, Ahmadi Hospital, Kuwait Oil Company, Fahaheel, Kuwait.
Nursing Department, Ahmadi Hospital, Kuwait Oil Company, Fahaheel, Kuwait.
出版信息
Eur J Case Rep Intern Med. 2020 Sep 29;7(12):001954. doi: 10.12890/2020_001954. eCollection 2020.
UNLABELLED
A 39-year-old woman who was taking the contraceptive pill was admitted with right leg deep venous thrombosis (DVT). She was started on apixaban tablets, but after 8 days developed proximal progression of the DVT and pulmonary embolism. Her medical history later showed a history of sleeve gastrectomy. The patient responded to a vitamin K antagonist after heparin. The failure of the antithrombotic drug shed light on the efficacy and changed pharmacodynamics of direct oral anticoagulants (DOACs) after bariatric surgery in the absence of commercially available blood monitoring tests.
LEARNING POINTS
Bariatric surgery causes complicated changes in the pharmacodynamics of direct oral anticoagulants (DOACs).The absence of clinical data on the efficacy of DOACs after various bariatric procedures makes it difficult to justify their use after bariatric surgery.
未标注
一名正在服用避孕药的39岁女性因右下肢深静脉血栓形成（DVT）入院。她开始服用阿哌沙班片，但8天后出现DVT近端进展和肺栓塞。她的病史后来显示有袖状胃切除术史。患者在使用肝素后对维生素K拮抗剂有反应。在缺乏可商购的血液监测检测的情况下，抗血栓药物的失效揭示了减肥手术后直接口服抗凝剂（DOACs）的疗效及改变的药效学。
学习要点
减肥手术导致直接口服抗凝剂（DOACs）的药效学发生复杂变化。各种减肥手术后缺乏关于DOACs疗效的临床数据，使得难以证明其在减肥手术后的使用合理性。
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