[静脉血栓栓塞症的抗凝治疗与出血风险:重点关注预测评分的使用。]

Q3 Medicine Recenti progressi in medicina Pub Date : 2024-09-01 DOI:10.1701/4334.43177
Laura M Cavagna, Mario Bazzan
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引用次数: 0

摘要

静脉血栓栓塞症(Vte)的标准治疗方法是抗凝。药物选择和治疗时间取决于临床表现、是否存在诱发因素、出血风险以及患者的偏好。抗凝治疗适用于所有急性 Vte 患者,疗程为 3-6 个月,但也可延长,甚至在某些情况下无限期延长。抗凝治疗最严重的副作用是出血,最高风险出现在治疗的最初几个月。如何平衡 Vte 患者的出血风险和复发风险仍是一个重要问题。目前还没有简单有效的预测评分来估计接受抗凝治疗的患者的长期出血风险,并安全地选择出血风险较高的患者。在本综述中,我们将研究其中的一些评分,包括 RIETE 评分、HAS-BLED 评分、VTE-BLEED 评分、VTE- PREDICT 和 ACCP 指南,以及在接受 VTE 治疗的患者群体中应用这些评分的时机,以及血栓栓塞性疾病的初始和长期管理与评估。
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[Anticoagulant therapy in venous thromboembolism and bleeding risk: focus on the use of predictive scores.]

The standard treatment for venous thromboembolism (Vte) is anticoagulation. Drug selection and treatment duration will depend on the clinical presentation, the existence of provoking factors, bleeding risk, and the patient's preferences. Anticoagulation therapy is indicated for 3-6 months in all patients with acute Vte but may be extended, even indefinitely in some cases. The most severe side effect of anticoagulation is bleeding, with the highest risk occurring during the 1st months of therapy. Balancing the risk of bleeding and the risk of recurrence in patients with Vte remain a major issue. There are, currently, no simple and validated predictive scores to estimate the long-term bleeding risk in patients undergoing anticoagulant treatment and to safely select those patients with higher bleeding risk. In this review we will examine some of these scores, including the RIETE scores, the HAS-BLED SCORE, the VTE-BLEED score, the VTE- PREDICT and the ACCP guidelines and the timing for their application in the patient's population treated for Vte as well as the initial and long-term management and evaluation of thromboembolic disease.

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来源期刊
Recenti progressi in medicina
Recenti progressi in medicina Medicine-Medicine (all)
CiteScore
0.90
自引率
0.00%
发文量
143
期刊介绍: Giunta ormai al sessantesimo anno, Recenti Progressi in Medicina continua a costituire un sicuro punto di riferimento ed uno strumento di lavoro fondamentale per l"ampliamento dell"orizzonte culturale del medico italiano. Recenti Progressi in Medicina è una rivista di medicina interna. Ciò significa il recupero di un"ottica globale e integrata, idonea ad evitare sia i particolarismi della informazione specialistica sia la frammentazione di quella generalista.
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