凝血酶原复杂集中和新鲜冷冻血浆华法林的逆转。系统回顾和荟萃分析。
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Chai-Adisaksopha C,希利斯C, Siegal DM,事实上R,综丝N,人工,克洛泽M
凝血酶原复杂集中和新鲜冷冻血浆华法林的逆转。系统回顾和荟萃分析。
Thromb Haemost。2016年8月4日,116 (4)。
- PubMed ID
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27488143 (在PubMed]
- 文摘
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迫切需要逆转华法林的患者体验主要出血或需要紧急手术。治疗方案包括维生素K的结合和与凝血酶原凝血因子替代复杂的集中(PCC)或新鲜冷冻血浆(FFP)。然而,最优反转策略基于临床相关的结果还不清楚。我们搜必威国际app查了MEDLINE、EMBASE和Cochrane图书馆2015年12月。13(5 8随机研究和观察性研究)的研究都包括在内。PCC使用显著减少全因死亡率相比FFP(或= 0.56,95%可信区间;0.37 - -0.84,p = 0.006)。更高比例的患者接受PCC达到止血与那些接受FFP相比,但这不是统计学意义(或2.00,95%可信区间;0.85 - -4.68)。PCC使用更有可能实现正常化国际正常化率(INR)(或10.80,95%可信区间; 6.12-19.07) and resulted in a shorter time to INR correction (mean difference -6.50 hours, 95 %CI; -9.75 to -3.24). Red blood cell transfusion was not statistically different between the two groups (OR 0.88, 95 % CI: 0.53-1.43). Patients receiving PCC had a lower risk of post-transfusion volume overload compared to FFP (OR 0.27, 95 % CI; 0.13-0.58). There was no statistically significant difference in the risk of thromboembolism following administration of PCC or FFP (OR 0.91, 95 % CI; 0.44-1.89). In conclusion, as compared to FFP, the use of PCC for warfarin reversal was associated with a significant reduction in all-cause mortality, more rapid INR reduction, and less volume overload without an increased risk of thromboembolic events.
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