含或不含维生素K的4因子凝血酶原复合浓缩物在治疗华法林相关性大出血中的有效性。

IF 1.2 Q3 MEDICINE, GENERAL & INTERNAL
Şeyma Arzu Temür, Mustafa Selçuk Ayar, Yiğit Kurnaz, Fatih Çalışkan
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引用次数: 0

摘要

背景:大出血是与使用维生素K拮抗剂相关的常见且严重的并发症。在急性出血的情况下,迅速逆转抗凝是至关重要的。凝血酶原复合物浓缩物(PCC)已成为一种有效的选择。本研究探讨了4因子PCC (4F-PCC)单独和联合维生素K对华法林所致危及生命的出血患者的国际标准化比率(INR)控制的疗效。方法:这项回顾性横断面研究纳入了2022年1月1日至2023年1月1日期间在Ondokuz Mayıs大学卫生实践与研究中心成人急诊科就诊的50例出血和凝血功能障碍患者。根据24小时内给予维生素K的情况将患者分为两组:1组仅给予4F-PCC, 2组同时给予4F-PCC和维生素K。结果:患者年龄中位数为72岁,男性占56%。华法林最常见的适应症是心脏瓣膜疾病(54%)。胃肠道出血是出血的主要原因(44%)。死亡率为26%,所有死亡均发生在入院后72小时内。2组患者24小时INR水平显著低于1组(P= 0.048)。两组患者第1小时和第24小时INR水平均无显著差异(P < 0.05)。结论:本研究表明,4F-PCC联合维生素K比单独使用4F-PCC更有效地控制INR,但对反弹INR的增加没有显著影响。需要进一步的前瞻性、多中心研究来证实这些发现并探索长期结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effectiveness of 4-Factor Prothrombin Complex Concentrate with and without Vitamin K in Managing Warfarin-Associated Major Bleeding.

Background: Major bleeding is a common and severe complication associated with vitamin K antagonist use. Rapid reversal of anticoagulation is crucial in cases of acute bleeding. Prothrombin complex concentrates (PCC) have emerged as an effective option. This study examines the efficacy of 4-factor PCC (4F-PCC) alone and in combination with vitamin K for International Normalized Ratio (INR) control in patients with life-threatening bleeding due to warfarin. Methods: This retrospective cross-sectional study included 50 patients who presented with bleeding and coagulopathy to the Ondokuz Mayıs University Health Practice and Research Center Adult Emergency Department between January 1, 2022, and January 1, 2023. Patients were divided into 2 groups based on vitamin K administration within 24 hours: group 1 received only 4F-PCC, while group 2 received both 4F-PCC and vitamin K. Results: The median age of patients was 72 years, 56% were male. The most common indication for warfarin use was heart valve disease (54%). Gastrointestinal hemorrhage was the leading cause of bleeding (44%). Mortality was 26%, with all deaths occurring within 72 hours of admission. Group 2 had significantly lower INR levels at 24th-hour than group 1 (P=.048). No significant differences were found in INR levels between the 1st and 24th hours within either group (P > .05). Conclusion: The study demonstrates that the combination of 4F-PCC and vitamin K is more effective in controlling INR than 4F-PCC alone, though it does not significantly impact rebound INR increases. Further prospective, multicenter studies are needed to confirm these findings and explore long-term outcomes.

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来源期刊
Eurasian Journal of Medicine
Eurasian Journal of Medicine Medicine-Medicine (all)
CiteScore
1.90
自引率
6.70%
发文量
59
审稿时长
16 weeks
期刊介绍: Eurasian Journal of Medicine (Eurasian J Med) is an international, scientific, open access periodical published by independent, unbiased, and triple-blinded peer-review principles. The journal is the official publication of Atatürk University School of Medicine and published triannually in February, June, and October. The publication language of the journal is English. The aim of the Eurasian Journal of Medicine is to publish original research papers of the highest scientific and clinical value in all medical fields. The Eurasian J Med also includes reviews, editorial short notes and letters to the editor that either as a comment related to recently published articles in our journal or as a case report. The target audience of the journal includes researchers, physicians and healthcare professionals who are interested or working in in all medical disciplines.
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