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美国血液病学会(ASH)于2020年10月发布的静脉血栓栓塞(VTE)管理指南,针对深静脉血栓(DVT和肺栓塞(PE)的治疗提出了最新推荐意见,笔者结合我国抗凝药物具体情况,对指南中VTE的抗栓综合管理进行解读,内容涵盖VTE患者的治疗管理、复发性事件的处理以及VTE合并心血管疾病的治疗建议等。指南推荐新诊断VTE患者的治疗管理分为初始管理、初级治疗和二级预防3个阶段。强烈推荐包括对PE和血流动力学受损的患者先溶栓再抗凝,对使用维生素K拮抗剂作为二级预防的VTE患者的INR范围应控制在2.0～3.0,对复发的不明原因VTE患者应无限期抗凝。
Abstract：In October 2020, the American Society of Hematology(ASH) released the guidelines for management of venous thromboembolism(VTE), in which latest recommendations were presented for the treatment of deep vein thrombosis(DVT) and pulmonary embolism(PE). Based on the specific situation of our country's anticoagulant drugs,the comprehensive antithrombotic management of VTE patients is interpreted in this article, which covers the treatment and management of VTE patients, the treatment of recurrence events, and the treatment recommendations for VTE combined with cardiovascular disease. The guideline recommends that the therapeutic management of patients with newly diagnosed VTE can be divided into three stages: initial management, primary treatment and secondary prevention. Strong recommendations include the use of thrombolytic therapy and then anticoagulation for patients with PE and hemodynamic compromise, use of an international normalized ratio(INR) range of 2.0 to 3.0 for patients with VTE who use a vitamin K antagonist for secondary prevention, and use of indefinite anticoagulation for patients with recurrent unprovoked VTE.
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基本信息:
DOI：10.14109/j.cnki.xyylc.2021.11.12
中图分类号:R563.5;R543.6
引用信息:
[1]韩丽珠,尹琪楠,边原,等.深静脉血栓和肺栓塞的管理与治疗：对美国血液病学会静脉血栓栓塞管理指南的解读[J].中国新药与临床杂志,2021,40(11):784-788.DOI:10.14109/j.cnki.xyylc.2021.11.12.
基金信息:
国家重点研发计划（2020YFC2005506）; 个体化药物治疗四川省重点实验室开放课题（2021ZD01）; 四川省干部保健科研课题（川干研2021-226）; 四川省医学会静脉血栓栓塞症防治专项科研课题（2019HR02）
2021-10-20
2021-10-20
2021-10-20