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特殊人群使用止血药物的临床应用专家共识
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| 篇名： | 特殊人群使用止血药物的临床应用专家共识 |
| TITLE： | Clinical application of hemostatic drugs in special populations：an expert consensus |
| 摘要： | 目的 基于循证医学证据，形成特殊人群使用止血药物的临床实践推荐，提升用药有效性和安全性。方法由四川省医学科学院·四川省人民医院牵头，组建涵盖临床药学、妇产科、儿科等多领域专家的工作组，共79位专家。通过文献调研与两轮德尔菲法问卷调查，筛选特殊人群止血药物使用有效性、安全性相关临床问题；对干预性临床问题采用人群、干预、对照、结果框架进行结构化，对管理类问题采用人群、临床情境、管理措施和结局框架进行补充描述；系统检索Medline、Embase、CochraneLibrary、中国知网、万方和维普等数据库，收集并筛选相关证据，并通过推荐意见问卷调研及专家共识会议形成推荐意见，同时依据推荐意见分级的评估、制订及评价系统对证据质量和推荐意见强度进行分级。结果与结论最终确定8个临床问题，所有临床问题及推荐意见的共识率均＞90%，形成8条关于特殊人群使用止血药物的推荐意见，覆盖儿童、妊娠期/产褥期/哺乳期女性、老年、肝功能不全、肝移植围手术期、肾功能不全/透析/肾移植围手术期、免疫功能受抑制及血液系统疾病患者等特殊人群。推荐内容明确了不同特殊人群中止血药物的适用情境、剂量调整原则、监测指标及安全管理策略，可为特殊人群的止血药物临床应用提供参考，帮助临床医师与药师制订个体化用药方案。 |
| ABSTRACT： | OBJECTIVE To develop evidence-based clinical practice recommendations for the use of hemostatic drugs in special populations， so as to improve the efficacy and safety of medication.METHODS Led by the Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital， a working group of 79 experts covering clinical pharmacy， obstetrics and gynecology， pediatrics and other fields was established. Clinical questions regarding the efficacy and safety of hemostatic drugs in special populations were screened through literature review and two rounds of Delphi questionnaire surveys. Intervention questions were structured using the population， intervention， comparison， and outcome framework， while management questions were additionally described using the population， clinical setting, management measure， and outcome framework. Databases including Medline， Embase， Cochrane Library， CNKI， Wanfang Data， and VIP were systematically searched to collect and screen relevant evidence. Recommendations were formulated through recommendation questionnaire surveys and expert consensus meetings， and the quality of evidence and strength of recommendations were graded according to the Grading of Recommendations Assessment， Development and Evaluation system. RESULTS &CONCLUSIONS A total of 8 clinical questions were finally determined， the consensus rates of all clinical questions and recommendations were more than 90%， and 8 recommendations on the use of hemostatic drugs in special populations were formulated. These recommendations cover special populations including children， women during pregnancy/puerperium/lactation， the elderly， patients with hepatic impairment， patients in the perioperative period of liver transplantation， patients with renal impairment/on dialysis/in the perioperative period of kidney transplantation， immunocompromised patients， and patients with hematological diseases. The recommendations specify the applicable scenarios， dose adjustment principles， monitoring indicators， and safety management strategies of hemostatic drugs in different special populations， which can provide a reference for the clinical application of hemostatic drugs in special populations and help clinicians and pharmacists develop individualized medication plans. |
| 期刊： | 2026年第37卷第20期 |
| 作者： | 韩丽珠；边原；尹琪楠；陈思颖；于菲菲；陈静；崔星星；唐一丁；姚芯；刘泓希；梁淑红；刘楠 |
| AUTHORS： | HAN Lizhu，BIAN Yuan，YIN Qinan，CHEN Siying， YU Feifei，CHEN Jing，CUI Xingxing，TANG Yiding，YAO Xin，LIU Hongxi，LIANG Shuhong，LIU Nan |
| 关键字： | 止血药物;特殊人群;PICO;GRADE;儿童;产褥期;老年;肝功能不全;肾功能不全;专家共识 |
| KEYWORDS： | hemostatic drugs;special populations;PICO;GRADE;Children;puerperium;Elderly;hepatic impairment;renal impairment;Expert Consensus |
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