癌症与血栓：新疗法，新挑战。
Cancer and Thrombosis: New Treatments, New Challenges.
机构信息
Department of Hematology, Akershus University Hospital, 1478 Lørenskog, Norway.
Institute of Clinical Medicine, University of Oslo, 0316 Oslo, Norway.
出版信息
Med Sci (Basel). 2021 Jun 3;9(2):41. doi: 10.3390/medsci9020041.
Abstract
The direct-acting oral anticoagulant (DOAC) has become an alternative to low-molecular-weight heparin (LMWH) for treatment and prophylaxis of venous thromboembolism (VTE) in cancer patients. The clinicians are, however, faced with difficult decisions regarding DOAC treatment: Which patients cannot use DOACs? Should incidental VTE be treated similar to symptomatic VTE? Is it safe to give DOACs to patients with gastrointestinal or urogenital cancers? How about drug-drug interactions? Should all cancer patients receive thromboprophylaxis? Is arterial thrombosis a problem? The current article reviews the available literature regarding these questions and aims to provide practical solutions based on data from the clinical trials and new guidelines.
摘要
直接口服抗凝剂（DOAC）已成为癌症患者静脉血栓栓塞症（VTE）治疗和预防的低分子肝素（LMWH）替代药物。然而，临床医生在 DOAC 治疗方面面临着艰难的决策：哪些患者不能使用 DOAC？偶然发生的 VTE 是否应与症状性 VTE 进行类似治疗？将 DOAC 给予胃肠道或泌尿生殖道癌症患者是否安全？药物相互作用如何？是否所有癌症患者都应接受血栓预防？动脉血栓形成是否存在问题？本文综述了有关这些问题的现有文献，并旨在根据临床试验和新指南的数据提供实际解决方案。
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