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[AHA2011]抗栓治疗研究进展——Jeffrey Weitz 教授专访
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作者:JeffreyWeitz 编辑:国际循环网 时间:2011/11/16 19:00:09 关键字:PTT  肝素 深静脉血栓  磺达肝素钠  导管血栓 

    <International Circulation>:  With pregnant women, they are at a significantly increased risk for VTE.  Are there any standard procedures in terms of preventative measures for VTE in pregnant women?
   《国际循环》:怀孕妇女,VTE的风险显著增加。是否存在适用于孕妇的预防VTE的措施?
 
    Prof. Weitz: In general, although they are at increased risk, the risk is very low.  We encourage mobility as a primary measure and potentially thromboprophylaxis if the patient undergoes ceserean section, but generally there are no other preventative measures.   Obesity is another risk factor for VT.  Of course there will be some weight gain during pregnancy but if the woman starts off with a high amount of adiposity then that is an additional risk factor.  The more important thing is the patient who has a prior history of venous thromboembolism or has a known thrombophilic defect.  What do we do with those patients to prevent VTE?  Those patients would be at high risk and we would often give prophylaxis throughout pregnancy and for a period of time post-partum.
    Weitz教授:一般来说,尽管她们的风险增加,但是这个风险还是非常低的。如果患者接受流产治疗,我们鼓励灵活地采取主要的或者潜在的血栓预防措施。肥胖是VT的另一个危险因素。当然在孕期体重会有所增加但是如果孕妇在一个较高的基数上增加体重的话这就是一个额外影响因素。更重要的是之前有过静脉血栓栓塞病史的患者或者已经明确有易形成血栓的倾向。我们对于这类患者如何预防VTE?那些存在将有高危血栓倾向的患者,我们将在整个孕期以及产后的一段时期内采取预防措施。
 
    <International Circulation>:  Regarding unprovoked VTE, yesterday in your talk you said that for provoked VTE you generally treat for about three months or until the risk factors go away.  For unprovoked VTE you generally treat for three months then re-evaluate, is that right?
   《国际循环》:对于无明显原因的VTE,在您昨天的讨论中您说对于有继发性的VTE,您通常治疗3个月左右直至危险因素消失。那么对于无诱因的VTE,您一般之3个月之后重新评估,对吗?

    Prof. Weitz:  Most of those patients get extended treatment so many will be on long term anticoagulant therapy.  I don’t like to say life-long because we re-evaluate periodically and in some cases the therapy can cease.  Some experts will keep this type of patient on anticoagulants forever unless the risk of bleeding becomes too high to preclude that treatment. 
Weitz教授: 大多数患者延长治疗时间因此很多人会接受长期的抗凝治疗。我认为不应该终生抗凝治疗,因为我们会定期重新评估,某些患者可以停止抗凝治疗。一些专家将使此类患者坚持抗凝治疗直至出血的风险 很高以至于不能再耐受抗凝治疗。
 



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