{"id":99313,"date":"2019-05-14T00:00:50","date_gmt":"2019-05-17T08:20:47","guid":{"rendered":"http:\/\/www.05921.net\/index.php\/99313\/"},"modified":"2019-05-17T16:20:48","modified_gmt":"2019-05-17T08:20:48","slug":"7877180b70","status":"publish","type":"post","link":"https:\/\/www.05921.net\/index.php\/99313\/","title":{"rendered":"3 \u4e2a\u75c5\u4f8b\u6559\u4f60\u641e\u5b9a\u764c\u75c7\u76f8\u5173\u9759\u8109\u8840\u6813\u6813\u585e"},"content":{"rendered":"
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\"3<\/p>\n


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\u5728 blood \u6742\u5fd7\uff0c\u5f00\u8bbe\u4e86\u4e00\u4e2a\u4e13\u680f How I Treat\uff0c\u7ecf\u5e38\u6709\u524d\u8f88\u544a\u8bc9\u5c0f\u533b\u751f\u4eec\uff0c\u4f60\u4eec\u4e0d\u77e5\u9053\u600e\u4e48\u770b\u75c5\uff0c\u5c31\u53bb\u770b\u770b how I treat\u2026<\/span>
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\"3<\/p>\n


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\u4eca\u5929\u7684\u8fd9\u4e00\u671f How I Treat \u5c06\u6559\u6211\u4eec\u5982\u4f55\u5904\u7406\u764c\u75c7\u76f8\u5173\u7684\u9759\u8109\u8840\u6813\u6813\u585e\u3002<\/span><\/p>\n


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\"3<\/p>\n


<\/p>\n<\/section>\n

\u9759\u8109\u8840\u6813\u6813\u585e (VTE) \u662f\u764c\u75c7\u5e38\u89c1\u7684\u5e76\u53d1\u75c7\uff0c\u5305\u62ec\u6df1\u9759\u8109\u8840\u6813 (DVT) \u548c\u80ba\u6813\u585e (PE)\uff0c\u5177\u6709\u5f88\u9ad8\u7684\u53d1\u75c5\u7387\u548c\u6b7b\u4ea1\u7387\u3002\u51e0\u79cd\u4e0e\u764c\u75c7\u76f8\u5173\u7684\u5371\u9669\u56e0\u7d20\u4fc3\u8fdb\u4e86 VTE \u7684\u53d1\u5c55\uff0c\u5305\u62ec\u764c\u75c7\u7c7b\u578b\u548c\u9636\u6bb5\u3001\u5316\u7597\u3001\u624b\u672f\u548c\u4e0e\u60a3\u8005\u76f8\u5173\u7684\u56e0\u7d20\u5982\u9ad8\u9f84\u3001\u5236\u52a8\u7b49\u3002<\/span><\/p>\n


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<\/p>\n

\u764c\u75c7\u60a3\u8005\u53d1\u751f VTE \u7684\u98ce\u9669\u662f\u975e\u764c\u75c7\u60a3\u8005\u7684 4-7 \u500d\uff0c\u636e\u62a5\u9053\u5e74\u53d1\u751f\u8840\u6813\u6982\u7387\u9ad8\u8fbe 15%\u3002\u764c\u75c7\u60a3\u8005\u53d1\u751f VTE \u7684\u9ad8\u5371\u56e0\u7d20\u5305\u62ec\u60a3\u8005\u65b9\u9762\u3001\u6cbb\u7597\u65b9\u9762\u3001\u80bf\u7624\u76f8\u5173\u56e0\u7d20\uff08\u8868 1\uff09\u3002<\/span><\/p>\n


<\/span><\/p>\n\n\n\n\n\n
\n

\u80bf\u7624\u60a3\u8005\u4e2dVTE\u7684\u98ce\u9669\u56e0\u7d20<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

\u60a3\u8005\u65b9\u9762\u7684\u56e0\u7d20\uff1a<\/span><\/p>\n

\u9ad8\u9f84\uff0c\u5408\u5e76\u75c7\uff0c\u5236\u52a8\u6216\u4f4f\u9662\uff0c\u65e2\u5f80\u6709VTE\uff0c\u9057\u4f20\u6027\u8840\u6813\u5f62\u6210\u503e\u5411<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

\u80bf\u7624\u76f8\u5173\u56e0\u7d20\uff1a<\/span><\/p>\n

1\uff09\u80bf\u7624\u7c7b\u578b\uff1a<\/span><\/p>\n\n\n\n\n\n
\n

\u975e\u5e38\u9ad8\u98ce\u9669\uff1a\u80c3\uff0c\u80f0\u817a\uff0c\u8111\uff1b<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

\u9ad8\u98ce\u9669\uff1a\u80ba\uff0c\u8840\u6db2\uff0c\u5987\u4ea7\uff0c\u80be\u810f\u8180\u80f1<\/span><\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

2\uff09  \u80bf\u7624\u5206\u671f<\/span><\/p>\n

3\uff09  \u7ec4\u7ec7\u5b66\u80bf\u7624\u5206\u7ea7<\/span><\/p>\n

4\uff09  \u5c40\u90e8\u80bf\u7624\u538b\u8feb<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

\u6cbb\u7597\u76f8\u5173\u7684\u56e0\u7d20\uff1a<\/span><\/p>\n

1\uff09  \u5316\u7597\uff08\u4f8b\u5982\u987a\u94c2\u4e3a\u57fa\u7840\u7684\uff0c\u6297\u8840\u7ba1\u751f\u6210\u7c7b\u836f\u7269\uff09<\/span><\/p>\n

2\uff09  \u5185\u5206\u6ccc\u6cbb\u7597<\/span><\/p>\n

3\uff09  \u7ea2\u7ec6\u80de\u8f93\u6ce8\u6216\u8005\u4fc3\u7ea2\u7ec6\u80de\u751f\u6210\u7d20<\/span><\/p>\n

4\uff09  \u624b\u672f<\/span><\/p>\n

5\uff09  \u653e\u7597<\/span><\/p>\n

6\uff09  \u6df1\u9759\u8109\u7f6e\u7ba1<\/span><\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

\u8868 1 \u80bf\u7624\u60a3\u8005\u4e2d VTE \u7684\u98ce\u9669\u56e0\u7d20<\/span><\/p>\n


<\/p>\n

\u4e00\u65e6\u53d1\u751f VTE\uff0c\u51e0\u4e4e\u6240\u6709\u60a3\u8005\u90fd\u4f1a\u5f00\u59cb\u6297\u51dd\u6cbb\u7597\u3002\u4f46\u76ee\u524d VTE \u7684\u7ba1\u7406\u4ecd\u7136\u5145\u6ee1\u6311\u6218\uff0c\u5373\u4f7f\u6297\u51dd\u6cbb\u7597\uff0cVTE \u4ecd\u6709\u53ef\u80fd\u590d\u53d1\uff0c\u540c\u65f6\u80bf\u7624\u60a3\u8005\u51fa\u8840\u98ce\u9669\u4e5f\u6bd4\u975e\u80bf\u7624\u60a3\u8005\u8981\u9ad8\u3002\u5728\u8fd9\u7bc7\u7efc\u8ff0\u4e2d\uff0c\u901a\u8fc7\u8ba8\u8bba 3 \u4f8b\u80bf\u7624\u76f8\u5173\u7684 VTE \u60a3\u8005\u7ba1\u7406\u6765\u6307\u5bfc\u6cbb\u7597\u3002<\/span><\/p>\n


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\n
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\u75c5\u4f8b 1\uff1a\u6df1\u9759\u8109\u8840\u6813\uff08DVT\uff09<\/span><\/section>\n<\/section>\n
\n
\n
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<\/p>\n

61 \u5c81\u7537\u6027\uff0c\u8fd1\u671f\u8bca\u65ad\u4e3a IIa \u671f\u524d\u5217\u817a\u764c\uff0c\u56e0\u300c\u53f3\u4e0b\u80a2\u80bf\u80c0\u75bc\u75db\u4f34\u7ea2\u6591 3 \u5929\u300d\u6025\u8bca\u5c31\u8bca\u3002B \u8d85\u63d0\u793a\u8fd1\u7aef\u4e0b\u80a2\u6df1\u9759\u8109\u8840\u6813\u3002\u5bf9\u4e8e\u8fd9\u4e2a\u75c5\u4eba\uff0c\u5408\u9002\u7684\u6297\u51dd\u6cbb\u7597\u65b9\u6848\u662f\u4ec0\u4e48\u5462\uff1f<\/span><\/p>\n<\/section>\n<\/section>\n

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<\/section>\n<\/section>\n<\/section>\n<\/section>\n


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\u5efa\u8bae 1
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<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n


<\/p>\n

\u591a\u5e74\u6765\uff0c\u4f4e\u5206\u5b50\u809d\u7d20 (LMWHs) \u4e00\u76f4\u4ee5\u6765\u90fd\u662f\u80bf\u7624\u76f8\u5173\u8840\u6813\u7684\u4e00\u7ebf\u6cbb\u7597\u3002<\/span>\u4f4e\u5206\u5b50\u809d\u7d20\u80fd\u964d\u4f4e\u8840\u6813\u590d\u53d1\uff0c\u4e14\u548c\u7ef4\u751f\u7d20 K \u62ee\u6297\u5242 (VKAs) \u76f8\u6bd4\u4e0d\u589e\u52a0\u5927\u51fa\u8840\u98ce\u9669\u3002\u5728\u975e\u764c\u75c7\u7684 VTE \u60a3\u8005\u4e2d\uff0c\u53e3\u670d\u6297\u51dd\u5242\uff08DOACS\uff09\u5df2\u6210\u4e3a\u9996\u9009\u3002\u53e3\u670d\u6297\u51dd\u5242\u5728\u764c\u75c7\u60a3\u8005\u7684\u6709\u6548\u6027\u548c\u5b89\u5168\u6027\u8bc1\u636e\u662f\u7f3a\u4e4f\u7684\u3002<\/span><\/p>\n


<\/p>\n

\u6700\u8fd1\uff0c\u4e24\u4e2a\u968f\u673a\u8bd5\u9a8c\u7684\u7ed3\u679c\u6bd4\u8f83 DOACS \u5230 LMWH \u6cbb\u7597\u764c\u75c7\u76f8\u5173\u8840\u6813\u53d1\u8868\u4e86\u3002<\/strong><\/p>\n


<\/p>\n

\u5206\u522b\u662f the Hokusai VTE Cancer \u548c SELECT-D \u4e34\u5e8a\u8bd5\u9a8c\uff0c\u6709\u7cfb\u7edf\u56de\u987e\u7efc\u5408\u5206\u6790\u4e86\u8fd9\u4e24\u4e2a\u7814\u7a76\uff0c\u4f7f\u7528 DOACS \u7684\u764c\u75c7\u60a3\u8005 VTE \u590d\u53d1\u7387\uff0c\u4e0e\u4f7f\u7528\u4f4e\u5206\u5b50\u809d\u7d20\u76f8\u6bd4\uff0c \u66f4\u4f4e\uff08RR\uff0c0.65\uff1b95%CI\uff0c0.42-1.01\uff09\u3002\u7136\u800c\uff0c6 \u4e2a\u6708\u65f6\uff0c\u4f7f\u7528 DOACS \u7684\u60a3\u8005\u51fa\u8840\u7387\u8f83\u9ad8\uff08RR\uff0c1.74\uff1b95%CI\uff0c1.05-2.88\uff09\u3002<\/strong><\/p>\n


<\/p>\n

\u7efc\u5408\u8d77\u6765\uff0cDOAC\uff0c\u4f9d\u591a\u6c99\u73ed\uff08edoxaban\uff09\u548c rivaroxaban \u4f3c\u4e4e\u53ef\u66ff\u4ee3\u4f4e\u5206\u5b50\u91cf\u809d\u7d20\u6cbb\u7597\u764c\u75c7\u60a3\u8005\u7684\u9759\u8109\u8840\u6813\u6813\u585e\u3002<\/span>\u7136\u800c\uff0c\u5728\u764c\u75c7\u76f8\u5173\u8840\u6813\u5f62\u6210\u7684\u60a3\u8005\u5236\u5b9a\u6297\u51dd\u7ba1\u7406\u65f6\u5e94\u8003\u8651\u4ee5\u4e0b\u56e0\u7d20\uff1a<\/span><\/p>\n


<\/p>\n

1. <\/span>\u60a3\u8005\u7684\u504f\u597d\u5728\u6574\u4e2a\u51b3\u7b56\u8fc7\u7a0b\u4e2d\u662f\u6700\u91cd\u8981\u7684\u56e0\u7d20<\/span>\u3002\u4ece\u60a3\u8005\u7684\u89d2\u5ea6\u6765\u770b\uff0c\u60a3\u8005\u7684\u8f6c\u5f52\u4e0e\u764c\u75c7\u76f8\u5173\u7684\u6f5c\u5728\u5ef6\u8fdf\u6216\u80bf\u7624\u76f8\u5173\u836f\u7269\u76f8\u4e92\u4f5c\u7528\u6709\u5173\u3002<\/span><\/p>\n


<\/p>\n

2. <\/span>\u6297\u51dd\u6cbb\u7597\u7684\u7597\u6548\u548c\u5b89\u5168\u6027<\/span>\u3002\u5927\u591a\u6570\u60a3\u8005\u89c9\u5f97\u836f\u7247\u66f4\u65b9\u4fbf\uff0c\u4f46\u4f4e\u5206\u5b50\u91cf\u809d\u7d20\u5728\u764c\u75c7\u53ca\u5176\u76f8\u5173\u75be\u75c5\u4e2d\u4ecd\u7136\u662f\u53ef\u4ee5\u63a5\u53d7\u7684\u3002\u9700\u8981\u4e0e\u60a3\u8005\u6c9f\u901a\uff0c\u624d\u80fd\u5f62\u6210\u4e00\u4e2a\u5e73\u8861\u6709\u6548\u7684\u51b3\u7b56\u3002<\/span><\/p>\n


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\n
\n
\n
<\/section>\n
<\/section>\n
<\/section>\n<\/section>\n
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\u56de\u5230\u75c5\u4f8b 1<\/span><\/section>\n<\/section>\n<\/section>\n


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\n
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\u6025\u6027\u671f\u6cbb\u7597<\/span><\/strong>\uff1a\u60a3\u8005\u5f53\u65f6\u6ca1\u6709\u63a5\u53d7\u4efb\u4f55\u764c\u75c7\u65b9\u9762\u7684\u6cbb\u7597\u3002\u4ed6\u5426\u8ba4\u4ee5\u524d\u6709\u8fc7\u51fa\u8840\u4e8b\u4ef6\uff0c\u5e76\u8868\u793a\u4ed6\u66f4\u559c\u6b22\u53e3\u670d\u800c\u4e0d\u662f\u6ce8\u5c04\u6cbb\u7597\u3002\u4f53\u91cd 78 \u516c\u65a4\uff0c\u80be\u529f\u80fd\u5728\u6b63\u5e38\u8303\u56f4\uff0c\u808c\u9150\u6e05\u9664\u7387\u4e3a 80 \u6beb\u5347\/\u5206\u949f\u3002<\/span><\/p>\n


<\/p>\n

\u7528 5 \u5929\u7684\u6cbb\u7597\u6027\u4f4e\u5206\u5b50\u809d\u7d20\uff08\u4f9d\u8bfa\u809d\u7d20\uff0c\u76ae\u4e0b\u6ce8\u5c04 1 mg\/kg\uff1b\u6bcf\u65e5\u4e24\u6b21\uff09\u6cbb\u7597\uff0c\u968f\u540e\u53e3\u670d\u4f9d\u591a\u6c99\u73ed\uff08edoxaban\uff0960 \u6beb\u514b\uff0c\u6bcf\u5929\u4e00\u6b21\uff0c\u6700\u5c11\u53e3\u670d 6 \u4e2a\u6708\u3002<\/span><\/p>\n


<\/p>\n

\u540e\u671f\u968f\u8bbf<\/span><\/strong>\uff1a6 \u4e2a\u6708\u540e\uff0c\u60a3\u8005\u8fd4\u56de\u8fdb\u884c\u95e8\u8bca\u968f\u8bbf\u3002\u4ed6\u7ee7\u7eed\u670d\u7528\u6297\u51dd\u5242\uff0c\u5426\u8ba4\u4efb\u4f55\u590d\u53d1\u6027 VTE \u6216\u51fa\u8840\u4e8b\u4ef6\u3002\u6700\u8fd1\u7684\u5b9e\u9a8c\u5ba4\u68c0\u67e5\u8868\u660e\u524d\u5217\u817a\u7279\u5f02\u6027\u6297\u539f\u6c34\u5e73\u5347\u9ad8\u548c CT \u63d0\u793a\u591a\u53d1\u6027\u8fdc\u7aef\u690e\u4f53\u3001\u76c6\u9aa8\u8f6c\u79fb\u3002<\/span><\/p>\n


<\/p>\n

\u60a3\u8005\u9042\u5f00\u59cb\u4e86\u96c4\u6fc0\u7d20\u53bb\u52bf\u6cbb\u7597\u8054\u5408\u591a\u897f\u4ed6\u8d5b\u3002\u90a3\u4e48\u9488\u5bf9\u665a\u671f\u764c\u75c7\u60a3\u8005\uff0c\u662f\u5426\u9700\u8981\u5ef6\u957f\u6297\u51dd\u6cbb\u7597\u5462\uff1f<\/span><\/p>\n<\/section>\n<\/section>\n

<\/section>\n
<\/section>\n<\/section>\n<\/section>\n<\/section>\n


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\n
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\u5efa\u8bae 2
<\/section>\n
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<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n


<\/p>\n

\u521d\u59cb\u6297\u51dd\u6cbb\u7597 3-6 \u4e2a\u6708\u540e\uff0c\u505c\u6b62\u6216\u7ee7\u7eed\u6297\u51dd\u6cbb\u7597\u7684\u51b3\u5b9a\u5e94\u57fa\u4e8e\u9759\u8109\u8840\u6813\u6813\u585e\u590d\u53d1\u98ce\u9669\u4e0e\u51fa\u8840\u5e76\u53d1\u75c7\u4e4b\u95f4\u7684\u5e73\u8861\uff0c\u9700\u8981\u7ed3\u5408\u60a3\u8005\u7684\u504f\u597d\u3001\u9884\u671f\u5bff\u547d\u3001\u4ee5\u53ca\u6cbb\u7597\u8d39\u7528\u3002\u4e13\u5bb6\u5171\u8bc6\u8ba4\u4e3a\u5728\u6d3b\u52a8\u6027\u764c\u75c7\u60a3\u8005\u4e2d\uff0c\u6297\u51dd\u6cbb\u7597\u5e94\u7ee7\u7eed\uff0c\u56e0\u4e3a\u764c\u75c7\u6d3b\u52a8\u662f VTE \u590d\u53d1\u7684\u4e00\u4e2a\u6301\u7eed\u6027\u4e3b\u8981\u5371\u9669\u56e0\u7d20\u3002<\/span><\/p>\n


<\/p>\n

\u56e0\u6b64\uff0c\u5efa\u8bae\u8be5\u665a\u671f\u524d\u5217\u817a\u764c\u60a3\u8005\u7ee7\u7eed\u6297\u51dd\u6cbb\u7597\u3002\u56e0\u4e3a\u4f9d\u591a\u6c99\u73ed\u4e0e\u96c4\u6fc0\u7d20\u53bb\u52bf\u836f\u7269\u53ca\u591a\u897f\u4ed6\u8d5b\u4e4b\u95f4\u65e0\u660e\u663e\u7684\u836f\u7269\u76f8\u4e92\u4f5c\u7528\uff0c\u5e76\u4e14\u51fa\u8840\u98ce\u9669\u4f4e\u3002\u7ee7\u7eed\u4f9d\u591a\u6c99\u73ed 60 \u6beb\u514b\uff0c\u53e3\u670d\uff0c\u6bcf\u65e5\u4e00\u6b21\uff0c 3 \u4e2a\u6708\u968f\u8bbf\uff0c\u91cd\u65b0\u8bc4\u4f30\u6297\u51dd\u6548\u679c\u6cbb\u7597\u3002<\/span><\/p>\n


<\/p>\n

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<\/p>\n

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\u75c5\u4f8b 2  \u5076\u53d1\u6027 PE<\/span><\/section>\n<\/section>\n
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\u7f16\u8f91\uff1adecie | \u8d23\u4efb\u7f16\u8f91\uff1a\u738b\u5f18<\/span><\/p>\n

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How I treat cancer-associated venous thromboembolism. Blood. 2019;133(4):291-298<\/span><\/p>\n<\/section><\/div>\n","protected":false},"excerpt":{"rendered":"

\u5728 blood \u6742\u5fd7\uff0c\u5f00\u8bbe\u4e86\u4e00\u4e2a\u4e13\u680f How I Treat\uff0c\u7ecf\u5e38\u6709\u524d\u8f88\u544a\u8bc9\u5c0f\u533b\u751f\u4eec\uff0c\u4f60\u4eec\u4e0d\u77e5\u9053\u600e\u4e48\u770b\u75c5\uff0c\u5c31\u53bb […]<\/p>\n","protected":false},"author":1,"featured_media":99314,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[1],"tags":[],"_links":{"self":[{"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/posts\/99313"}],"collection":[{"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/comments?post=99313"}],"version-history":[{"count":1,"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/posts\/99313\/revisions"}],"predecessor-version":[{"id":99321,"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/posts\/99313\/revisions\/99321"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/media\/99314"}],"wp:attachment":[{"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/media?parent=99313"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/categories?post=99313"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/tags?post=99313"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}