协和医学杂志

2018, v.9(02) 97-102

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抗凝与出血:临床决策的平衡与选择
Anticoagulation and Bleeding: Balancing the Benefit and the Risk in Clinical Decision-making

彭斌;崔丽英;
PENG Bin;CUI Li-ying;Department of Neurology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences &Peking Union Medical College;Neuroscience Center,Chinese Academy of Medical Sciences & Peking Union Medical College;

摘要(Abstract):

抗凝药物治疗和预防血栓性疾病的有效性早已得到证实,但抗凝治疗在显著降低血栓事件发生风险的同时,可能导致出血并发症,严重者可致命。临床实践中存在医师和患者过分顾虑抗凝治疗出血风险的现象,抗凝药物的使用率远低于预期,故评估抗凝治疗的获益与风险,制定合理的抗凝治疗方案,具有重要意义。临床需结合患者具体情况选择适用的评估量表,综合评估抗凝治疗,确定合适抗凝药物及剂量,加强抗凝治疗管理,在抗凝与出血之间找到平衡,作出合理选择。
Anticoagulation therapy is highly effective in preventing thromboembolism in patients with atrial fibrillation,deep vein thrombosis,or genetic predisposition,etc. Despite this advantage,however,anticoagulation results in an elevated risk of bleeding that may sometimes be life-threatening. There is excess concern in patients and physicians about the risk of bleeding from anticoagulation,which leads to the use of anticoagulation reportedly much less than expected. It is crucial to assess the bleeding risk and balance the benefit and the risk in order to plan a proper therapeutic regimen. An optimal decision on the therapy is based on a good balance between anticoagulation and bleeding according to the patient condition,the choice of an appropriate evaluation scale,a comprehensive assessment of coagulation,the right selection of medicine and dosage,and the enforcement of the management of anticoagulation therapy.

关键词(KeyWords): 血栓形成;抗凝;出血
thromboembolism;anticoagulation;bleeding

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基金项目(Foundation): 国家重点研发计划(2016YFC0901004);; 首都卫生发展科研专项基金(2016-1-40117)

作者(Author): 彭斌;崔丽英;
PENG Bin;CUI Li-ying;Department of Neurology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences &Peking Union Medical College;Neuroscience Center,Chinese Academy of Medical Sciences & Peking Union Medical College;

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