Izigulana ezingezizo ezibukhali ezinenoveli coronavirus inyumoniya: i-heparin anticoagulation vs uthintelo oluqhelekileyo lwe-thrombus

Umthombo: ixesha lokuhlanganisa amayeza ehlabathi: ngoSeptemba 18, 2021

Uninzi lwezigulana zenyumoniya ze-coronavirus zigula ngokuphakathi kwaye ekuqaleni azidingi nkxaso yamalungu kwi-ICU.Inoveli coronavirus inyumoniya yasetyenziswa kuphononongo lwe-N Engl J Med ngo-Agasti ka-2021. Abaphandi baseCanada, eUnited States naseBrazil bapapashe uncwadi lwamandulo lwaseTshayina lokukhangela isiphumo sonyango lwe-heparin anticoagulation kwizigulana ezingaqatha kakhulu ezinenyumoniya yesithsaba esitsha.

Imvelaphi: inoveli coronavirus pneumonia inyanyaniswa nokufa kunye neengxaki ngenxa ye-thrombosis kunye nokudumba.Abaphandi bacinga ukuba inyumoniya ye-coronavirus inokuphucula iziphumo zezigulana ezingabalulekanga esibhedlele ezine-pneumonia entsha.

Iindlela: inoveli coronavirus inyumoniya (inkxaso engeyiyo ilungu), echazwa njengenqanaba lokhathalelo olungabalulekanga, yabelwa ngokungacwangciswanga kwiinkcazo ezi-2 ezisebenzayo: i-heparin anticoagulation okanye i-thrombus prophylaxis eqhelekileyo kweli qonga livulekileyo, eliguquguqukayo, elininzi, uvavanyo olulawulwayo.Isiphumo esiphambili sasiyinani leentsuku ngaphandle kwenkxaso ye-organ, ihlolwe ngumlinganiselo olandelelanayo odibanisa ukufa esibhedlele (amanqaku-1) kunye nenani leentsuku zezigulane ezisindileyo ukuba zikhuphe ngaphandle kwe-cardiovascular or breathing organ support up to day 21. Zonke iziphumo zesigulane zihlolwe kusetyenziswa imodeli yezibalo zaseBayesi kwaye zisekelwe kumanqanaba asisiseko e-D-dimer.

Iziphumo: xa i-dose yonyango ye-anticoagulation idibana nemilinganiselo yokuphakama kwangaphambili, uvavanyo lwayekwa.Phakathi kwezigulane ze-2219 kuhlalutyo lokugqibela, ukubanakho kwe-dose ye-anticoagulation yonyango ukwandisa inani leentsuku ngaphandle kwenkxaso ye-organ xa kuthelekiswa ne-thromboprophylaxis eqhelekileyo yayingu-98.6% (ukulungiswa okanye, 1.27; 95% CI, 1.03 ~ 1.58).Umahluko opheleleyo phakathi kwamaqela ekuhlengahlengisweni kokusinda ukukhupha ngaphandle kokuxhaswa kwamalungu kubonisa ukuba i-dose yonyango ye-anticoagulation yayingcono, kwaye umahluko phakathi kwamaqela amabini ngu-4.0% (0.5 ~ 7.2).Ithuba lokugqibela lokuphakama kwe-anticoagulation yedosi yonyango ngaphezu kwe-thromboprophylaxis eqhelekileyo yayingu-97.3%, 92.9% kunye ne-97.3% kwi-D-dimer cohort ephezulu, i-D-dimer cohort ephantsi kunye ne-D-dimer cohort engaziwayo, ngokulandelanayo.I-hemorrhage enkulu yenzeke kwi-1.9% kunye ne-0.9% yezigulane kwi-dose yonyango ye-anticoagulation iqela kunye neqela lokuthintela i-thrombosis, ngokulandelanayo.

Ukuqukumbela: icebo lenyumoniya ye-coronavirus entsha inokonyusa amathuba okusinda kunye nokukhutshwa kunye nokunciphisa ukusetyenziswa kwentliziyo okanye inkxaso yokuphefumla kwizigulana ezinenyumoniya engaqhelekanga.


Ixesha lokuposa: Sep-18-2021