围手术期止血药物的选择与药学监护专家共识  

Expert Consensus on the Selection and Pharmaceutical Care of Perioperative Hemostatic Drugs

作　　者：中国健康促进基金会医药知识管理专项基金专家委员会 中国药师协会围手术期用药工作委员会 中国心胸血管麻醉学会心血管药学分会 中国药理学会治疗药物监测研究专业委员会 赵志刚[2] 刘建平[3] 葛卫红[4] 姜海伦 官海静 张珞妃 闫奕龙 韦石凤 Medical Knowledge Management Special Fund Expert Committee of the China Health Promotion Foundation;Perioperative Medication Working Committee of the Chinese Pharmacists Association;Cardiovascular Pharmacy Branch of Chinese Society of Cardiothoracic and Vascular Anesthesiology;Division of Therapeutic Drug Monitoring,Chinese Pharmacological Society

机构地区：[1]不详 [2]首都医科大学附属北京天坛医院药学部 [3]北京中医药大学循证医学中心 [4]南京大学医学院附属鼓楼医院药学部

出　　处：《医药导报》2025年第1期7-23,共17页Herald of Medicine

基　　金：北京市医院管理局临床医学发展专项—扬帆计划(ZYLX201827)。

摘　　要：目的进一步规范围手术期止血药物的合理使用。方法采用世界卫生组织指南制订手册进行专家共识的研究设计。首先,系统检索、收集围手术期止血药物应用的常见问题,运用德尔菲法确定最终纳入的临床问题。随后,编写秘书组进行系统文献检索,对现有的原始研究、系统评价以及相关指南或专家共识进行综合评估,并按照推荐分级的评估、制订与评价(GRADE)分级系统进行质量评价。最后,再次通过德尔菲法就推荐意见与证据级别达成共识,形成《围手术期止血药物的选择与药学监护专家共识》(简称《共识》)。结果在《共识》制订过程中,通过调查问卷的形式收集了22位来自临床药学、医学、检验学、循证医学、医院管理和卫生经济学等多个领域的专家对31项临床问题的评估意见。最终,根据专家意见确定纳入21项临床问题,并在编写专家组的指导和审核专家组的监督下制订了16项临床用药的推荐意见。结论该《共识》全面评估了8大类共20种止血药物在围手术期的应用效果和安全性,为临床工作人员提供了明确的使用建议。Objective This consensus aims to further standardize the rational use of hemostatic drugs in the perioperative period.Methods The study design of the consensus followed the World Health Organization guideline development handbook.Initially,common questions regarding the application of perioperative hemostatic drugs were systematically searched and collected.The Delphi method was then used to determine the clinical questions to be included.Subsequently,a secretariat team conducted a systematic literature search to comprehensively evaluate existing original research,systematic reviews,and related guidelines or expert consensus.Quality evaluation was performed according to the Grading of Recommendations Assessment,Development and Evaluation(GRADE)system.Finally,consensus on recommendation opinions and evidence levels was reached again through the Delphi method,resulting in the“Expert Consensus on the Selection and Pharmaceutical Care of Perioperative Hemostatic Drugs”.Results During the consensus development process,assessment opinions on 31 clinical questions from 22 experts in the fields of clinical pharmacy,medicine,laboratory medicine,evidence-based medicine,hospital management,and health economics were collected through questionnaires.Ultimately,based on expert opinions,21 clinical questions were included,and 16 clinical medication recommendations were developed under the direction of the writing expert group and the supervision of the review expert panel.Conclusion This consensus comprehensively evaluates the efficacy and safety of 20 hemostatic drugs across 8 major categories during the perioperative period,providing clear guidance for healthcare professionals.

关 键 词：围手术期 出血 止血药物 药学监护 专家共识 

分 类 号：R973.1[医药卫生—药品] R95[医药卫生—药学]