新型口服抗凝药在经皮左心耳封堵术后应用的研究进展  

Research progress on the application of novel oral anticoagulants after percutaneous left atrial appendage closure

作　　者：王玮 王永[1] WANG Wei;WANG Yong(Department of Cardiovascular Medicine,the Second People’s Hospital of Wuhu,Anhui Province,Wuhu 241000,China)

机构地区：[1]安徽省芜湖市第二人民医院心血管内科,安徽芜湖241000

出　　处：《中国医药导报》2023年第21期58-61,共4页China Medical Herald

基　　金：安徽省芜湖市科技计划项目(2022cg26)。

摘　　要：心房颤动包括瓣膜性心房颤动与非瓣膜性心房颤动,具有发病率高、预后差等特点,严重威胁人类生命健康。经皮左心耳封堵术(PLAAC)已经广泛应用于治疗存在高出血风险或有口服抗凝药物禁忌证的非瓣膜性心房颤动患者,虽然PLAAC用于治疗难以耐受抗凝治疗风险的患者有一定的风险,但其仍然是治疗心房颤动患者的重要举措。器械相关血栓、缺血性脑卒中为PLAAC术后常见的并发症,临床上常采用华法林、维生素K拮抗剂等抗凝药物治疗,但这些药物的实际使用效果往往是次优的。目前,各指南推荐PLAAC术后以抗凝治疗为主的方案,抗凝治疗尤其是新型口服抗凝药(NOACs)在PLAAC术后应用的安全性与有效性仍需要进一步研究。本文归纳并探讨NOACs在PLAAC术后的应用研究。Atrial fibrillation includes valvular atrial fibrillation and non-valvular atrial fibrillation.It has the characteristics of high morbidity and poor prognosis,which seriously threatens human life and health.Percutaneous left atrial appendage closure(PLAAC)has been widely used in the treatment of patients with non-valvular atrial fibrillation who have a high risk of bleeding or contraindications to oral anticoagulants.Although PLAAC has some risks for patients who have difficulty tolerating the risks of anticoagulant therapy,it remains an important step in the treatment of patients with atrial fibrillation.Device-related thrombus and ischemic stroke are common complications after PLAAC.Anticoagulant drugs such as Warfarin and vitamin K antagonists are often used in clinical treatment,but the actual effect of these drugs is often sub-optimal.At present,various guidelines recommend the regimentation of anticoagulation therapy after PLAAC surgery,the safety and effectiveness of anticoagulation therapy,especially the novel oral anticoagulant(NOACs)after PLAAC surgery still needs further research.This article summarizes and discusses the application research of NOACs after PLAAC surgery.

关 键 词：新型口服抗凝药 经皮左心耳封堵术 并发症 安全性 有效性 

分 类 号：R973.2[医药卫生—药品]