关节置换术后静脉血栓栓塞症的药物预防循证方案  

Drug prophylaxis evidence-based regimens for venous thromboembolism after joint replacement

作　　者：冯潇纬 郭娜 王宝珍 程杰[2] 唐雨晨 齐君 董志强 FENG Xiaowei;GUO Na;WANG Baozhen;CHENG Jie;TANG Yuchen;QI Jun;DONG Zhiqiang(School of Pharmacy,Baotou Medical College,Inner Mongolia University of Science&Technology,Inner Mongolian Baotou 014040,China;Dept.of Pharmaceutical Clinical Research,the First Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science&Technology,Inner Mongolian Baotou 014040,China)

机构地区：[1]内蒙古科技大学包头医学院药学院,内蒙古包头014040 [2]内蒙古科技大学包头医学院第一附属医院药物临床研究室,内蒙古包头014040

出　　处：《中国药房》2024年第22期2799-2807,共9页China Pharmacy

基　　金：内蒙古自治区高等学校科学技术研究自然科学重点项目(No.NJZZ22074);包头医学院科学研究基金项目自然科学类青苗计划项目(No.BYJJ-ZRQM202324);内蒙古医学科学院公立医院科研联合基金科技项目(No.2023GLLH0183)。

摘　　要：目的梳理人工关节置换术后成人患者发生静脉血栓栓塞症(VTE)的药物预防方案,为临床提供依据。方法按照“6S”模型检索英国国家卫生与临床优化研究所(NICE)、苏格兰校际指南网络(SIGN)、国际指南协作网(GIN)、美国国立实践技术指南库(NGC)、PubMed、Embase、中国知网、万方数据、中国生物医学文献服务系统和相关官方网站,纳入研究预防人工关节置换术后成人患者VTE的指南、专家共识、系统评价、随机对照试验和队列研究,检索时限为建库起至2023年12月。选出符合纳入标准的文献,由2名研究人员独立完成文献质量评价,并采用乔安娜布里格斯研究所(JBI)证据预分级及证据推荐级别系统(2014版)对其进行证据评定。结果共纳入36篇文献,涵盖风险评估、评估后预防措施、药物选择、药物使用方法、药物预防时间、药物预防观察要点、药物预防禁忌证、出血应对措施、健康教育9个方面,总结形成37条人工关节置换术后VTE的药物预防证据。结论本研究总结出的人工关节置换术后VTE的药物预防证据较为全面,具有一定的科学性和实用性,可为临床药师提供科学的围术期VTE预防管理循证依据。OBJECTIVE To sort out drug prophylaxis regimens for venous thromboembolism(VTE)in adult patients after artificial joint replacement,and provide a basis for clinic.METHODS Databases and related official websites were searched according to the“6S”model,including the National Institute for Health and Clinical Excellence(NICE),the Scottish Intercollegiate Guidelines Network(SIGN),the Guidelines International Network(GIN),the National Guidelines Clearinghouse(NGC),PubMed,Embase,CNKI,Wanfang database and SinoMed,to search for guidelines,expert consensuses,systematic evaluations,randomized controlled trials,and cohort studies about preventing VTE in adult patients after artificial joint replacement from the inception until December 2023.Literature that met the inclusion criteria were selected,and the quality evaluation of the literature was completed by 2 researchers independently;the evidence rating was performed by using the Joanna Briggs Institute(JBI)evidence pre-classification and evidence rank system(2014 edition).RESULTS A total of 36 articles were included in the study,which were categorized into 9 areas of risk assessment,post-assessment prophylaxis,medication selection,medication method,duration of medication prophylaxis,medication prophylaxis observation points,contraindications to drug prophylaxis,response to bleeding,and health education,which were summarized to form 37 pieces of evidence on the pharmacological prophylaxis for postoperative VTE in patients who underwent artificial joint replacement.CONCLUSIONS The evidence of drug prophylaxis for postoperative VTE in patients who underwent artificial joint replacement summarized in this study is comprehensive,with certain scientific reference and practicality,which can provide clinical pharmacists with a scientific evidence-based basis for perioperative VTE prophylaxis management.

关 键 词：静脉血栓栓塞症 人工关节置换术 药物预防 循证药学 

分 类 号：R973.2[医药卫生—药品]