中国药房2026，Vol.37Issue(6)：689-699,11.DOI:10.6039/j.issn.1001-0408.2026.06.01
围手术期应用胃肠外直接凝血酶抑制剂的专家共识
Expert consensus on clinical application of parenteral direct thrombin inhibitors in perioperative period
摘要
Abstract
OBJECTIVE To form an expert consensus on the clinical application of parenteral direct thrombin inhibitors(DTIs)in patients during the perioperative period.METHODS Led by Sichuan Academy of Medical Sciences&Sichuan Provincial People's Hospital(the Affiliated Hospital of UESTC),a multidisciplinary working group was established.Through literature review and the Delphi method,clinical questions related to the rational perioperative use of parenteral DTIs were identified.A structured design was adopted using the"Population-Intervention-Comparison-Outcome"framework;systematic searches were conducted in CNKI,Medline,Embase and other databases.Relevant evidence from randomized controlled trials and cohort studies was included and synthesized.Evidence quality was assessed using the Grades of Recommendations Assessment,Development and Evaluation(GRADE)approach,and recommendations were formulated through multiple rounds of Delphi surveys and expert consensus meetings.RESULTS&CONCLUSIONS Seven recommendations(each with an expert consensus rate exceeding 90%)on the use of parenteral DTIs in perioperative patients were developed.These recommendations specify drug selection,dosing ranges,key monitoring points,and safety management strategies for parenteral DTIs in various scenarios,including the perioperative period of ventricular assist device implantation,the perioperative period of cardiac surgery,perioperative patients with lower-extremity atherosclerotic disease,the perioperative period of percutaneous coronary intervention in patients with acute coronary syndrome,the perioperative period of carotid artery stenting in patients with carotid stenosis,the perioperative period of patients with right heart thrombosis,and patients who develop related thrombosis and dysfunction after a central venous catheter insertion.In addition,warning and management pathways for perioperative bleeding and thrombotic events were proposed.This expert consensus,which is formulated based on the best available evidence,provides evidence-based guidance for standardized and individualized use of parenteral DTIs in perioperative period.关键词
胃肠外直接凝血酶抑制剂/围手术期/抗凝/血栓/合理用药/专家共识Key words
parenteral direct thrombin inhibitors/perioperative period/anticoagulation/thromboembolism/rational drug use/expert consensus分类
医药卫生引用本文复制引用
蒋明玉,唐利,王易,梁淑红,刘会娟,肖桂荣,李玥,边原,韩丽珠,尹琪楠,康凤娇,魏安华,赵丹洁,王琳,邵英..围手术期应用胃肠外直接凝血酶抑制剂的专家共识[J].中国药房,2026,37(6):689-699,11.基金项目
四川省自然科学基金(No.2022NSFSC0818) （No.2022NSFSC0818）
四川省医学科学院·四川省人民医院个体化药物治疗四川省重点实验室开放和自拟课题(No.2021ZD01) （No.2021ZD01）
