用于血栓预防的抗血小板治疗：是前进还是后退？
Antiplatelet treatment for thromboprophylaxis: a step forward or backwards?
作者信息
Cohen A T, Skinner J A, Kakkar V V
机构信息
Thrombosis Research Institute, London.
出版信息
BMJ. 1994 Nov 5;309(6963):1213-5. doi: 10.1136/bmj.309.6963.1213.
Abstract
A recent meta-analysis from the Antiplatelet Trialists' Collaboration recommended that antilatelet treatment either alone or, for greater effect, in addition to other proved forms of thromboprophylaxis should be considered for patients at high risk of thromboembolism. This paper argues that the current evidence does not justify the adoption of aspirin or other antiplatelet treatment for venous thromboprophylaxis, especially when more effective alternatives exist. Furthermore, several issues relating to this latest meta-analysis need to be debated.
摘要
抗血小板试验协作组最近的一项荟萃分析建议，对于有血栓栓塞高风险的患者，应考虑单独使用抗血小板治疗，或者为了增强效果，在采用其他已证实的血栓预防方法的基础上再加用抗血小板治疗。本文认为，目前的证据并不支持采用阿司匹林或其他抗血小板治疗进行静脉血栓预防，尤其是在存在更有效替代方法的情况下。此外，与这项最新荟萃分析相关的几个问题有待探讨。
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本文引用的文献
1
Aspirin as an antiplatelet drug.阿司匹林作为一种抗血小板药物。
N Engl J Med. 1994 May 5;330(18):1287-94. doi: 10.1056/NEJM199405053301808.
2
Low molecular weight versus standard heparin for prevention of venous thromboembolism after major abdominal surgery. The Thromboprophylaxis Collaborative Group.低分子量肝素与标准肝素预防腹部大手术后静脉血栓栓塞。血栓预防协作组。
Lancet. 1993 Jan 30;341(8840):259-65. doi: 10.1016/0140-6736(93)92614-y.
3
Prophylaxis of postoperative thromboembolism by low dose heparin and by acetylsalicylic acid given simultaneously. A double blind study.
Thromb Res. 1980;17(1-2):177-84. doi: 10.1016/0049-3848(80)90304-7.
4
Prevention of venous thromboembolism after total knee replacement by high-dose aspirin or intermittent calf and thigh compression.高剂量阿司匹林或间歇性小腿及大腿加压预防全膝关节置换术后静脉血栓栓塞
Br Med J. 1980 Feb 23;280(6213):514-7. doi: 10.1136/bmj.280.6213.514.
5
[Prophylaxis of thromboembolism in abdominal surgery. Comparison of low dose heparin, acetylsalicylic acid and their combination (author's transl)].
MMW Munch Med Wochenschr. 1980 Oct 24;122(43):1495-8.
6
Meta-analysis in clinical trials.临床试验中的荟萃分析。
Control Clin Trials. 1986 Sep;7(3):177-88. doi: 10.1016/0197-2456(86)90046-2.
7
Reduction in fatal pulmonary embolism and venous thrombosis by perioperative administration of subcutaneous heparin. Overview of results of randomized trials in general, orthopedic, and urologic surgery.围手术期皮下注射肝素可降低致命性肺栓塞和静脉血栓形成的发生率。普通外科、骨科和泌尿外科手术随机试验结果综述。
N Engl J Med. 1988 May 5;318(18):1162-73. doi: 10.1056/NEJM198805053181805.
8
Meta-analysis in epidemiology, with special reference to studies of the association between exposure to environmental tobacco smoke and lung cancer: a critique.流行病学中的荟萃分析，特别提及环境烟草烟雾暴露与肺癌关联的研究：一篇评论
J Clin Epidemiol. 1991;44(2):127-39. doi: 10.1016/0895-4356(91)90261-7.
9
Can meta-analyses be trusted?
Lancet. 1991 Nov 2;338(8775):1127-30. doi: 10.1016/0140-6736(91)91975-z.
10
Low-molecular-weight heparin versus standard heparin in general and orthopaedic surgery: a meta-analysis.
Lancet. 1992 Jul 18;340(8812):152-6. doi: 10.1016/0140-6736(92)93223-a.
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