住院患者的静脉血栓栓塞预防:美国内科医师学会的临床实践指南

被引：6

作者：

俞羚

邹静

李焰生

机构：

[1] 上海交通大学医学院附属仁济医院神经科

来源：

神经病学与神经康复学杂志 | 2011年 / 8卷 / 04期

关键词：

出血风险; DVT; 肺栓塞; 出血事件; 肝素治疗; 机械性预防; 血栓栓塞; VTE; 静脉; 住院患者; 住院病人; 急性卒中; 症状性; 内科医师; 内科患者; 临床实践指南; 加压弹力袜; 美国; 美利坚合众国; 北美洲;

D O I：

暂无

中图分类号：

R543.6 [静脉疾病];

学科分类号：

1002 ; 100201 ;

摘要：

概述美国内科医师学会(ACP)发布此指南旨在为住院的非外科患者(内科患者和急性卒中患者)的静脉血栓栓塞预防提供证据和提出临床推荐。方法此指南是以1950年～2011年4月已发表的关于此主题的文献为基础,通过使用MEDLINE、Cochrane图书馆来检索,另外为确定更多的报道也对相关随机对照试验和系统性综述的参考文献进行了检索。检索被限制为随机对照试验和英文出版物。此指南的主要结局是随机后120 d的总死亡率。次要结局包括症状性深静脉血栓、所有的肺栓塞、致死性肺栓塞、所有出血事件、主要出血事件以及机械性预防对皮肤的影响。此指南使用ACP的临床实践指南分级系统对证据和推荐进行了分级。推荐对于内科患者(包括卒中患者),在启动预防静脉血栓栓塞前应评估血栓栓塞和出血风险(级别:强烈推荐,中等证据)。除非经评估的出血风险大于可能的益处,否则临床医师应使用肝素或其他相关药物对内科患者(包括卒中患者)的静脉血栓栓塞进行药物预防(级别:强烈推荐,中等质量证据)。反对使用逐级加压弹力袜机械性预防静脉血栓栓塞(级别:强烈推荐,中等质量证据)。不支持将不考虑风险的统一的VTE预防作为绩效测量用于这些(包括卒中)患者。

引用

页码：183 / 189

页数：7

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