JAHA:磺达肝素钠与低分子量肝素在围手术期血栓预防的疗效比较

2019-05-15 xing.T 网络

在这项荟萃分析中,磺达肝素在降低静脉血栓栓塞方面具有更高的疗效。然而,它也与大出血的几率增加有关。

在围手术期血栓预防的随机对照试验中,已将磺达肝素钠与低分子量肝素(LMWH)进行了比较。然而,这些研究的结果在达到临床决策的功效和安全性方面并不是一致的。近日,血管疾病领域权威杂志JAHA上发表了一篇研究文章,该研究的目的是系统地回顾随机对照试验,以比较磺达肝癸钠和LMWH治疗围手术期外科血栓预防的疗效和安全性。 

研究人员在各种数据库中进行系统检索以确定比较2000至2017年期间发表关于磺达肝素与LMWH的随机对照试验。本研究中感兴趣的结果包括15天静脉血栓栓塞、90天全因死亡、大出血、治疗期间轻微出血。研究人员使用Mantel-Haenszel统计学基于随机效应模型的相对几率进行分析。结果表达为比值比和95%CI。根据Cochrane协作进行研究质量评估。

在筛选了10644项研究后,12项随机对照试验(包括14906名患者)被纳入最终分析。汇总分析显示磺达肝素组静脉血栓栓塞的几率是LMWH组的0.49倍(OR=0.49[0.38-0.64])。然而,磺达肝素组大出血的几率是LMWH组的1.48倍(OR=1.48[1.15-1.90])。

在这项荟萃分析中,磺达肝素在降低静脉血栓栓塞方面具有更高的疗效。然而,它也与大出血的几率增加有关。
 
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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1801477, encodeId=bf4118014e74a, content=<a href='/topic/show?id=4a65e388841' target=_blank style='color:#2F92EE;'>#磺达肝素钠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73888, encryptionId=4a65e388841, topicName=磺达肝素钠)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e524260, createdName=dinorsor524, createdTime=Fri Nov 22 10:17:00 CST 2019, time=2019-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1747681, encodeId=75b71e47681ad, content=<a href='/topic/show?id=73fe93955ff' target=_blank style='color:#2F92EE;'>#达肝素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93955, encryptionId=73fe93955ff, topicName=达肝素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=edf435938443, createdName=xlysu, createdTime=Sat Jun 15 03:17:00 CST 2019, time=2019-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2053862, encodeId=0138205386298, content=<a href='/topic/show?id=8f5a54442a1' target=_blank style='color:#2F92EE;'>#手术期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54442, encryptionId=8f5a54442a1, topicName=手术期)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/WQ1WyMBGic8d2fKdCe6Cm3vaRh4X8YnlumYndC46iagNCBl9Df8RtoCaQchnFtZldHUctGJjsgsyutUlu8vPq6yQ/132, createdBy=97862500016, createdName=ms3117646317107274, createdTime=Sat Feb 01 16:17:00 CST 2020, time=2020-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1813862, encodeId=eca8181386248, content=<a href='/topic/show?id=d3be939563c' target=_blank style='color:#2F92EE;'>#达肝素钠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93956, encryptionId=d3be939563c, topicName=达肝素钠)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec9955, createdName=windight, createdTime=Wed Jan 01 07:17:00 CST 2020, time=2020-01-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1268145, encodeId=59a612681455f, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Fri May 17 13:17:00 CST 2019, time=2019-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1516237, encodeId=c841151623e65, content=<a href='/topic/show?id=9fc98913163' target=_blank style='color:#2F92EE;'>#血栓预防#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89131, encryptionId=9fc98913163, topicName=血栓预防)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7ca010933746, createdName=12498cf9m38(暂无昵称), createdTime=Fri May 17 13:17:00 CST 2019, time=2019-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=366320, encodeId=7826366320f2, content=学习了,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzTetibytbqFDmFITWHyBWbxU7S9MYibgPSqvu0sYteH0N6zXqbU0Kf3Mbdb7yWM1Kud3zPgYBibE2SZ/0, createdBy=da7696924, createdName=qingfengqishi5, createdTime=Thu May 16 23:08:44 CST 2019, time=2019-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032160, encodeId=c313103216085, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Thu May 16 01:17:00 CST 2019, time=2019-05-16, status=1, ipAttribution=)]
    2019-06-15 xlysu
  5. 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16 23:08:44 CST 2019, time=2019-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032160, encodeId=c313103216085, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Thu May 16 01:17:00 CST 2019, time=2019-05-16, status=1, ipAttribution=)]
  6. 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16 23:08:44 CST 2019, time=2019-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032160, encodeId=c313103216085, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Thu May 16 01:17:00 CST 2019, time=2019-05-16, status=1, ipAttribution=)]
  7. 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16 23:08:44 CST 2019, time=2019-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032160, encodeId=c313103216085, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Thu May 16 01:17:00 CST 2019, time=2019-05-16, status=1, ipAttribution=)]
    2019-05-17 zhaohui6731
  8. 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  9. 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encodeId=c841151623e65, content=<a href='/topic/show?id=9fc98913163' target=_blank style='color:#2F92EE;'>#血栓预防#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89131, encryptionId=9fc98913163, topicName=血栓预防)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7ca010933746, createdName=12498cf9m38(暂无昵称), createdTime=Fri May 17 13:17:00 CST 2019, time=2019-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=366320, encodeId=7826366320f2, content=学习了,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzTetibytbqFDmFITWHyBWbxU7S9MYibgPSqvu0sYteH0N6zXqbU0Kf3Mbdb7yWM1Kud3zPgYBibE2SZ/0, createdBy=da7696924, createdName=qingfengqishi5, createdTime=Thu May 16 23:08:44 CST 2019, time=2019-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032160, encodeId=c313103216085, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Thu May 16 01:17:00 CST 2019, time=2019-05-16, status=1, ipAttribution=)]
    2019-05-16 qingfengqishi5

    学习了,学习了

    0

  10. 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16 23:08:44 CST 2019, time=2019-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032160, encodeId=c313103216085, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Thu May 16 01:17:00 CST 2019, time=2019-05-16, status=1, ipAttribution=)]
    2019-05-16 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0