Antiphospholipid syndrome encompasses a range of clinical conditions, particularly thrombotic or obstetrical manifestations, associated with the presence of antiphospholipid antibodies. Managing thrombotic antiphospholipid syndrome in daily clinical practice can be challenging and requires thorough risk stratification and tailored treatment strategies. Primary prophylaxis focuses on improving traditional thrombosis risk factors and, in certain situations, may include low-dose aspirin and / or prophylactic anticoagulants (e.g., low-molecular-weight heparin). The treatment of thrombotic antiphospholipid syndrome primarily involves long-term anticoagulation with vitamin K antagonists. In some cases, a combination of vitamin K antagonists and low-dose aspirin, vitamin K antagonists with international normalized ratio target >3 or a switch to therapeutic doses of low-molecular-weight heparin might be employed. The use of hydroxychloroquine is essential for patients with secondary systemic lupus erythematosus and may be considered for patients with recurrent thrombosis. In other selected situations, the use of immunomodulatory agents can be considered.

2024-10-18·Head & neck

Effect of Low Molecular Weight Heparin Calcium on Prevention of Lower Limb Deep Venous Thrombosis in Oral Cancer Patients With Anterolateral Thigh Flap Reconstruction.

Article

作者: Wu, Kun ; Zhi, Yuan ; Lu, Linsong ; Gong, Zhaojian ; Zi, Moxin ; Zhang, Xiangyu ; Liu, Keyue

BACKGROUNDThis study aimed to evaluate the effect of low molecular weight heparin calcium (LMWH-Ca) on the prevention of deep venous thrombosis (DVT) in patients with anterolateral thigh (ALT) flap reconstruction.METHODSIn total, 1001 patients with oral cancer who underwent ALT flap reconstruction were recruited. Based on the postoperative use of LMWH-Ca, the patients were divided into case (n = 633) and control groups (n = 368). The incidence of postoperative DVT was compared between groups.RESULTSThere was no significant difference in DVT incidence between the two groups. Among patients older than 60 years, the incidence of lower limb DVT in the case group (0.813%) was significantly lower than that in the control group (8.108%, p = 0.012).CONCLUSIONThe postoperative use of LMWH in oral cancer patients with ALT flap transfer does not prevent the development of lower limb DVT. However, patients older than 60 years old benefited from the postoperative use of LMWH-Ca.

2024-10-01·The International Journal of Artificial Organs

Regional citrate anticoagulation versus LMWH anticoagulation for CRRT in liver failure patients without increased bleeding risk

Article

作者: Liu, Tong ; Zhang, Peng ; Zhao, Lijuan ; Liu, Yi ; Wu, Hao ; Tang, Siwei ; Lu, Rui ; Tang, Siyan ; Bai, Ming ; Yu, Yan

Background: The optimal anticoagulation regimen for continuous renal replacement therapy (CRRT) in liver failure (LF) patients without increased bleeding risk remains controversial. Therefore, we conducted a monocentric retrospective study to evaluate the efficacy and safety of the regional citrate anticoagulation (RCA) versus low molecular weight heparin (LMWH) anticoagulation for CRRT in LF without increased bleeding risk. Method: According to the anticoagulation strategy for CRRT, patients were divided into the RCA and LMWH-anticoagulation groups. The evaluated endpoints were patient survival, filter lifespan, bleeding, citrate accumulation, and totCa/ionCa ratio. Result: Totally 167 and 164 filters were used in the RCA and LMWH group, respectively. The median filter lifespan was significantly longer in the RCA group (34 h (IQR = 24–54) versus 24 h (IQR = 18–45.5) [95%CI, 24.5–33]; p < 0.001). The 4-week mortality rate was significantly higher in the LMWH-anticoagulation group (71 (57.72%) vs 53 (40.46%); p = 0.006). After adjusted the important parameters in the multivariate COX regression model, the mortality risk was significantly reduced in the RCA group (HR = 0.668 [95%CI, 0.468–0.955]; p = 0.027). In the LMWH group, 30 bleeding episodes (24,19%) were observed, whereas only 7 (5.34%) occurred in the RCA group ( p < 0.001). Two patients (1.5%) in the RCA group occurred citrate accumulation. Conclusions: In LF patients without increased bleeding risk who underwent CRRT, RCA significantly extended the filter lifespan and improved patient survival rate. There was no significant difference in the rate of adverse events between the two groups.

100 项与 Low-molecular-weight heparin 相关的药物交易

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