2025 直接口服抗凝剂指南—处方、 实验室检测、围手术期及出血管理.pdfVIP

doi:10.1111/imj.70103

POSITIONPAPER

2025Guidelinesfordirectoralanticoagulants:apractical

guidanceontheprescription,laboratorytesting,

peri-operativeandbleedingmanagement

HuyenA.Tran,1,2EileenMerriman,3RossBaker,4JenniferCurnow,5LauraYoung,6CheeWeeTan,7

SimonMcRae8andSanjeevD.Chunilal9

1HaemostasisThrombosisUnit,TheAlfredHospital,2AustralianCentreforBloodDiseases,MonashUniversity,and9HaematologyDepartment,

MonashMedicalCentre,Melbourne,Victoria,4HaematologyDepartment,PerthBloodInstitute,Perth,WesternAustralia,5HaematologyDepartment,

WestmeadHospital,Sydney,NewSouthWales,7HaematologyDepartment,RoyalAdelaideHospital,Adelaide,SouthAustralia,8Departmentof

Haematology,LauncestonGeneralHospital,Launceston,Tasmania,Australia,and3HaematologyDepartment,RoyalNorthShoreHospital,and

6HaematologyDepartment,AucklandCityHospital,Auckland,NewZealand

KeywordsAbstract

directoralanticoagulant,majorbleeding,

reversalagent,perioperativeanticoagulation.Directoralanticoagulants(DOACs)arewidelyprescribedtopreventandtreatvenous

andarterialthromboembolism,supportedbypublishedevidence,andarepreferredover

Correspondencewarfarininmanyguidelines.Althoughtheriskofmajorbleeding,inparticularintracranial

HuyenA.Tran,AustralianCentreforBloodhaemorrhage(ICH),isdecreasedwithDOACs,gastrointestinalbleedingisincreasedwith

Diseases,MonashUniversity,Melbourne,Vic.someDOACs,andthecasefatalityrateofbleedingremainshigh.Therefore,itisimportant

3800,Australia.