Comprehensive clinical assessment of parenteral anticoagulants for venous thromboembolism during pregnancy and puerperium
AIM To conduct a clinical comprehensive evaluation of parenteral anticoagulants in the management of venous thromboembolism during pregnancy and puerperium,providing a scientifically robust basis to guide the prudent use of these agents in clinical practice.METHODS The clinical utility of parenteral anticoagulants was evaluated,utilizing the Delphi method in conjunction with the Analytic Hierarchy Process(AHP).Clinical evaluation indicators were meticulously selected across 6 key dimensions:safety,efficacy,cost-effectiveness,appropriateness,innovation,and accessibility.Evidence-based evidence was collected and analyzed to construct a clinical comprehensive evaluation system for the application of parenteral anticoagulants in venous thromboembolism during pregnancy and puerperium.The system comprised 6 first-level indicators and 22 second-level indicators.The clinical comprehensive evaluation was conducted on low-molecular-weight heparin calcium/sodium,enoxaparin,nadroparin,bemiparin,dalteparin,and fondaparinux.RESULTS The evidence-based evidence for the 6 first-level indicators and 22 second-level indicators derived from systematic reviews(Meta-analysis),medicine instructions,clinical practice guidelines,and expert consensus,etc.According to the established clinical comprehensive evaluation system for the application of parenteral anticoagulants in venous thromboembolism disease during pregnancy and puerperium,various low-molecular-weight heparin agents were evaluated.The results revealed that nadroparin achieved the highest overall score in the evaluation,followed by enoxaparin,with bemiparin scoring the lowest.Specifically,fondaparinux had the highest safety and appropriateness scores,low-molecular-weight heparin and enoxaparin scored highest for effectiveness,enoxaparin for accessibility,and fondaparinux for innovation,with low molecular weight heparin leading in economy.CONCLUSION Various parenteral anticoagulants exhibit distinct advantages in treating venous thromboembolism during pregnancy and puerperium.A comprehensive clinical evaluation of parenteral anticoagulants used for the management of venous thromboembolic disease during pregnancy and the puerperium is conducted,aiming to provide a scientific basis for the rational use of parenteral anticoagulants in clinical practice.
万方数据
维普
