预防和管理心脏病患者肺栓塞的药物和非药物干预措施:文献综述

Dennys Paul Guaraca Huilcarema, Juan Carlos Yánez Tobar, Robinson David Moya Pilay, Shirly Andrea Pagalo Tacuri, Galo Fernando Tulcanaza Ochoa, Mishelle Estefania Garcés López, Melany Dayana Albán Galarza
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引用次数: 0

摘要

肺栓塞(PE)给医疗保健带来了巨大挑战,并可能造成危及生命的后果,因此需要采取细致入微的管理方法。本系统性综述旨在对治疗肺栓塞的现有药物和非药物干预措施进行批判性评估,分析其对心脏病合并症患者的疗效和安全性,包括华法林等传统抗凝剂、新型直接口服抗凝剂(DOACs)或溶栓疗法等具有不同优点和局限性的市售选择。包括导管导向疗法和栓子切除术在内的非药物干预措施提供了替代途径,尤其是在溶栓疗法尽管取得了进步但仍有禁忌时,但差距依然存在,特别是在协调疗效与安全性以及优化资源分配方面。要应对这些挑战,就必须采用多学科方法,将临床专业知识与循证实践相结合。通过探讨这些干预措施的复杂性和影响,本综述旨在为临床医生、研究人员和政策制定者提供信息,为面临复杂的 PE 管理问题的患者提供更好的治疗途径和更好的治疗效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pharmacological and Nonpharmacological Interventions for Prevention and Management of Pulmonary Embolism in Patients with Cardiac Comorbidities: A Literature Review
Pulmonary embolism (PE) presents significant healthcare challenges and potentially life-threatening consequences, demanding a nuanced approach to management. This systematic review aimed to critically evaluate available pharmacological and nonpharmacological interventions for PE, analyzing their efficacy and safety in patients with cardiac comorbiditie, ranging from traditional anticoagulants like warfarin to novel direct oral anticoagulants (DOACs) or thrombolytic therapies is commercially available options with varying benefits and limitations. Nonpharmacological interventions, including catheter-directed therapies and embolectomy, provide alternative avenues, especially when thrombolysis is contraindicated despite advancements, and gaps persist, particularly in reconciling efficacy with safety profiles and optimizing resource allocation. Addressing these challenges necessitates a multidisciplinary approach, integrating clinical expertise with evidence-based practices. By exploring these interventions' intricacies and implications, this review aims to inform clinicians, researchers, and policymakers, fostering improved care pathways and better outcomes for patients facing the complex landscape of PE management.
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