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癌症相关静脉血栓栓塞症治疗中的临床争议。

Clinical controversies in the treatment of cancer-associated venous thromboembolism.

机构信息

Department of Pharmacy Services and Clinical Sciences, Michigan Medicine, University of Michigan College of Pharmacy, Ann Arbor, MI, USA.

出版信息

J Oncol Pharm Pract. 2021 Jun;27(4):939-953. doi: 10.1177/1078155220984371. Epub 2021 Jan 12.

Abstract

Cancer-associated venous thromboembolism (VTE) is a common complication of malignancy. Patients with cancer exhibit risk factors for both recurrent VTE and major or minor bleeding. Direct oral anticoagulants (DOACs) are an attractive treatment option; however, there is a lack of consensus among national guidelines for choice between DOACs and LMWH, agent selection, dosing strategy, and duration of anticoagulation. Characteristics of the thrombotic event, the malignancy, the patient, and the anticoagulant must be considered. A systematic search of online databases was performed to identify literature on the management of cancer-associated VTE. Multiple controversies remain surrounding the optimal treatment of cancer-associated VTE.

摘要

癌症相关静脉血栓栓塞症(VTE)是恶性肿瘤的常见并发症。癌症患者存在复发性 VTE 以及大出血或小出血的风险因素。直接口服抗凝剂(DOAC)是一种有吸引力的治疗选择;然而,国家指南在 DOAC 与低分子肝素(LMWH)之间的选择、药物选择、剂量策略以及抗凝时间方面缺乏共识。必须考虑血栓形成事件、恶性肿瘤、患者和抗凝剂的特征。对在线数据库进行了系统搜索,以确定关于癌症相关 VTE 管理的文献。癌症相关 VTE 的最佳治疗方法仍存在诸多争议。

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