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Array ( [id] => 2157 [catid] => 311 [title] => 2022 ESC Guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery [thumb] => [keywords] => [description] => [hits] => [uid] => 3 [author] => 甘肃中医院 [status] => 9 [url] => https://www.anes-guide.com/show/2157.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.116 [inputtime] => 2024-12-19 09:42:42 [updatetime] => 2024-12-19 09:42:42 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 0 [wailian] => https://pubmed.ncbi.nlm.nih.gov/36017553/ [demo_url] => [zjpjff] => LOE [zjfj] => [tjqd] => [nianfen] => 2022 [guojia] => the European Society of Anaesthesiology and Intens [pdf] => [tjyjyw] => [lyyw] => LMWH is recommended, as an alternative to UFH, for bridging in patients with MHVs and high surgical risk.(Evidence: Level B，Recommendation: Class I) [laiyuan] => 行高风险手术的心脏机械瓣患者应使用低分子肝素替代普通肝素进行桥接。（证据级别：B；推荐强度：I） [znzldj] => A [_inputtime] => 1734572562 [_updatetime] => 1734572562 [_nrjc] => [_nrsh] => )
推荐意见
行高风险手术的心脏机械瓣患者应使用低分子肝素替代普通肝素进行桥接。（证据级别：B；推荐强度：I）

LMWH is recommended, as an alternative to UFH, for bridging in patients with MHVs and high surgical risk.(Evidence: Level B，Recommendation: Class I)

证据评价方法：LOE

指南质量等级：A

年份：2022

国家：the European Society of Anaesthesiology and Intens

来源 2022 ESC Guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery
原文链接
阅读
Array ( [id] => 2158 [catid] => 311 [title] => 2022 ESC Guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery [thumb] => [keywords] => [description] => [hits] => [uid] => 3 [author] => 甘肃中医院 [status] => 9 [url] => https://www.anes-guide.com/show/2158.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.116 [inputtime] => 2024-12-19 09:42:42 [updatetime] => 2024-12-19 09:42:42 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 0 [wailian] => https://pubmed.ncbi.nlm.nih.gov/36017553/ [demo_url] => [zjpjff] => LOE [zjfj] => [tjqd] => [nianfen] => 2022 [guojia] => the European Society of Anaesthesiology and Intens [pdf] => [tjyjyw] => [lyyw] => In patients using NOACs, it is recommended that minor bleeding risk procedures are performed at trough levels (typically 12–24 h after last intake).(Evidence: Level C，Recommendation: Class Ⅰ) [laiyuan] => 使用NOAC抗凝的患者，应在药物达低谷水平（最后一次用药后12～24 h）时进行出血风险小的手术。（证据级别：C；推荐强度：I） [znzldj] => A [_inputtime] => 1734572562 [_updatetime] => 1734572562 [_nrjc] => [_nrsh] => )
推荐意见
使用NOAC抗凝的患者，应在药物达低谷水平（最后一次用药后12～24 h）时进行出血风险小的手术。（证据级别：C；推荐强度：I）

In patients using NOACs, it is recommended that minor bleeding risk procedures are performed at trough levels (typically 12–24 h after last intake).(Evidence: Level C，Recommendation: Class Ⅰ)

证据评价方法：LOE

指南质量等级：A

年份：2022

国家：the European Society of Anaesthesiology and Intens

来源 2022 ESC Guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery
原文链接
阅读
Array ( [id] => 2159 [catid] => 311 [title] => 2022 ESC Guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery [thumb] => [keywords] => [description] => [hits] => [uid] => 3 [author] => 甘肃中医院 [status] => 9 [url] => https://www.anes-guide.com/show/2159.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.116 [inputtime] => 2024-12-19 09:42:42 [updatetime] => 2024-12-19 09:42:42 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 0 [wailian] => https://pubmed.ncbi.nlm.nih.gov/36017553/ [demo_url] => [zjpjff] => LOE [zjfj] => [tjqd] => [nianfen] => 2022 [guojia] => the European Society of Anaesthesiology and Intens [pdf] => [tjyjyw] => [lyyw] => For patients with mechanical prosthetic heart valves undergoing NCS, bridging with UFH or LMWH should be considered if OAC interruption is needed and patients have: (i) mechanical AVR and any thromboembolic risk factor; (ii)old-generation mechanical AVR; or (iii)mechanical mitral or tricuspid valve replacement.(Evidence: Level C，Recommendation: Class IIa) [laiyuan] => 心脏机械瓣患者行NCS手术时，如果是：（i）主动脉瓣机械置换和有任何血栓栓塞危险因素，（ii）老一代主动脉机械瓣置换，（iii）二尖瓣或三尖瓣机械瓣置换，需要暂停口服抗凝剂时，应使用低分子肝素或肝素进行桥接。（证据级别：C；推荐强度：IIa） [znzldj] => A [_inputtime] => 1734572562 [_updatetime] => 1734572562 [_nrjc] => [_nrsh] => )
推荐意见
心脏机械瓣患者行NCS手术时，如果是：（i）主动脉瓣机械置换和有任何血栓栓塞危险因素，（ii）老一代主动脉机械瓣置换，（iii）二尖瓣或三尖瓣机械瓣置换，需要暂停口服抗凝剂时，应使用低分子肝素或肝素进行桥接。（证据级别：C；推荐强度：IIa）

For patients with mechanical prosthetic heart valves undergoing NCS, bridging with UFH or LMWH should be considered if OAC interruption is needed and patients have: (i) mechanical AVR and any thromboembolic risk factor; (ii)old-generation mechanical AVR; or (iii)mechanical mitral or tricuspid valve replacement.(Evidence: Level C，Recommendation: Class IIa)

证据评价方法：LOE

指南质量等级：A

年份：2022

国家：the European Society of Anaesthesiology and Intens

来源 2022 ESC Guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery
原文链接
阅读
Array ( [id] => 2160 [catid] => 311 [title] => 2022 ESC Guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery [thumb] => [keywords] => [description] => [hits] => [uid] => 3 [author] => 甘肃中医院 [status] => 9 [url] => https://www.anes-guide.com/show/2160.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.116 [inputtime] => 2024-12-19 09:42:42 [updatetime] => 2024-12-19 09:42:42 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 0 [wailian] => https://pubmed.ncbi.nlm.nih.gov/36017553/ [demo_url] => [zjpjff] => LOE [zjfj] => [tjqd] => [nianfen] => 2022 [guojia] => the European Society of Anaesthesiology and Intens [pdf] => [tjyjyw] => [lyyw] => Bridging of OAC therapy is not recommended inpatients with low/moderate thrombotic riskundergoing NCS.(Evidence: Level B，Recommendation: Class III) [laiyuan] => 对于接受非心脏手术治疗的低/中度血栓风险患者，不建议使用口服抗凝剂桥接疗法。（证据级别：B；推荐强度：Ⅲ） [znzldj] => A [_inputtime] => 1734572562 [_updatetime] => 1734572562 [_nrjc] => [_nrsh] => )
推荐意见
对于接受非心脏手术治疗的低/中度血栓风险患者，不建议使用口服抗凝剂桥接疗法。（证据级别：B；推荐强度：Ⅲ）

Bridging of OAC therapy is not recommended inpatients with low/moderate thrombotic riskundergoing NCS.(Evidence: Level B，Recommendation: Class III)

证据评价方法：LOE

指南质量等级：A

年份：2022

国家：the European Society of Anaesthesiology and Intens

来源 2022 ESC Guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery
原文链接
阅读
Array ( [id] => 2161 [catid] => 311 [title] => 2022 ESC Guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery [thumb] => [keywords] => [description] => [hits] => [uid] => 3 [author] => 甘肃中医院 [status] => 9 [url] => https://www.anes-guide.com/show/2161.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.116 [inputtime] => 2024-12-19 09:42:42 [updatetime] => 2024-12-19 09:42:42 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 0 [wailian] => https://pubmed.ncbi.nlm.nih.gov/36017553/ [demo_url] => [zjpjff] => LOE [zjfj] => [tjqd] => [nianfen] => 2022 [guojia] => the European Society of Anaesthesiology and Intens [pdf] => [tjyjyw] => [lyyw] => If bleeding risk with resumption of full-dose anticoagulation outweighs the risk of thromboembolic events, postponing therapeutic anticoagulation 48–72 h after the procedure may be considered, using post-operative thromboprophylaxis until resumption of full OAC dose is deemed safe.(Evidence: Level C ，Recommendation: Class IIb) [laiyuan] => 如果恢复全量抗凝剂的出血风险超过血栓栓塞事件风险，应延迟治疗剂量的抗凝剂至术后48～72 h，并使用术后血栓预防直到恢复全量口服抗凝剂被认为是安全的。（证据级别：C；推荐强度：IIb） [znzldj] => A [_inputtime] => 1734572562 [_updatetime] => 1734572562 [_nrjc] => [_nrsh] => )
推荐意见
如果恢复全量抗凝剂的出血风险超过血栓栓塞事件风险，应延迟治疗剂量的抗凝剂至术后48～72 h，并使用术后血栓预防直到恢复全量口服抗凝剂被认为是安全的。（证据级别：C；推荐强度：IIb）

If bleeding risk with resumption of full-dose anticoagulation outweighs the risk of thromboembolic events, postponing therapeutic anticoagulation 48–72 h after the procedure may be considered, using post-operative thromboprophylaxis until resumption of full OAC dose is deemed safe.(Evidence: Level C ，Recommendation: Class IIb)

证据评价方法：LOE

指南质量等级：A

年份：2022

国家：the European Society of Anaesthesiology and Intens

来源 2022 ESC Guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery
原文链接
阅读
Array ( [id] => 2162 [catid] => 311 [title] => 2022 ESC Guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery [thumb] => [keywords] => [description] => [hits] => [uid] => 3 [author] => 甘肃中医院 [status] => 9 [url] => https://www.anes-guide.com/show/2162.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.116 [inputtime] => 2024-12-19 09:42:42 [updatetime] => 2024-12-19 09:42:42 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 0 [wailian] => https://pubmed.ncbi.nlm.nih.gov/36017553/ [demo_url] => [zjpjff] => LOE [zjfj] => [tjqd] => [nianfen] => 2022 [guojia] => the European Society of Anaesthesiology and Intens [pdf] => [tjyjyw] => [lyyw] => Use of reduced-dose NOAC to attenuate the risk of post-operative bleeding is not recommended.(Evidence: Level C，Recommendation: Class III) [laiyuan] => 不推荐 NOAC 减量使用以减轻术后出血风险。（证据级别：C；推荐强度：Ⅲ） [znzldj] => A [_inputtime] => 1734572562 [_updatetime] => 1734572562 [_nrjc] => [_nrsh] => )
推荐意见
不推荐 NOAC 减量使用以减轻术后出血风险。（证据级别：C；推荐强度：Ⅲ）

Use of reduced-dose NOAC to attenuate the risk of post-operative bleeding is not recommended.(Evidence: Level C，Recommendation: Class III)

证据评价方法：LOE

指南质量等级：A

年份：2022

国家：the European Society of Anaesthesiology and Intens

来源 2022 ESC Guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery
原文链接
阅读
Array ( [id] => 2163 [catid] => 311 [title] => 2022 ESC Guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery [thumb] => [keywords] => [description] => [hits] => [uid] => 3 [author] => 甘肃中医院 [status] => 9 [url] => https://www.anes-guide.com/show/2163.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.116 [inputtime] => 2024-12-19 09:42:42 [updatetime] => 2024-12-19 09:42:42 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 0 [wailian] => https://pubmed.ncbi.nlm.nih.gov/36017553/ [demo_url] => [zjpjff] => LOE [zjfj] => [tjqd] => [nianfen] => 2022 [guojia] => the European Society of Anaesthesiology and Intens [pdf] => [tjyjyw] => [lyyw] => It is recommended that decisions about peri-operative thromboprophylaxis in NCS are based on individual and procedure-specific risk factors.(Evidence: Level A ，Recommendation: Class I) [laiyuan] => 非心脏手术的围术期血栓预防应基于患者个体和手术特定的危险因素进行。（证据级别：A；推荐强度：I） [znzldj] => A [_inputtime] => 1734572562 [_updatetime] => 1734572562 [_nrjc] => [_nrsh] => )
推荐意见
非心脏手术的围术期血栓预防应基于患者个体和手术特定的危险因素进行。（证据级别：A；推荐强度：I）

It is recommended that decisions about peri-operative thromboprophylaxis in NCS are based on individual and procedure-specific risk factors.(Evidence: Level A ，Recommendation: Class I)

证据评价方法：LOE

指南质量等级：A

年份：2022

国家：the European Society of Anaesthesiology and Intens

来源 2022 ESC Guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery
原文链接
阅读
Array ( [id] => 2164 [catid] => 311 [title] => 2022 ESC Guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery [thumb] => [keywords] => [description] => [hits] => [uid] => 3 [author] => 甘肃中医院 [status] => 9 [url] => https://www.anes-guide.com/show/2164.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.116 [inputtime] => 2024-12-19 09:42:42 [updatetime] => 2024-12-19 09:42:42 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 0 [wailian] => https://pubmed.ncbi.nlm.nih.gov/36017553/ [demo_url] => [zjpjff] => LOE [zjfj] => [tjqd] => [nianfen] => 2022 [guojia] => the European Society of Anaesthesiology and Intens [pdf] => [tjyjyw] => [lyyw] => If thromboprophylaxis is deemed necessary, it is recommended to choose the type and duration of thromboprophylaxis (LMWH, NOAC, or fondaparinux) according to type of NCS, duration of immobilization, and patient-related factors.(Evidence: Level A ，Recommendation: Class I) [laiyuan] => 如果必须进行血栓预防时，应根据非心脏手术类型、卧床时间以及患者相关因素选择预防血栓药物的类型和治疗时间（低分子肝素、非维生素K口服抗凝剂或磺达肝癸钠）（证据级别：A；推荐强度：I） [znzldj] => A [_inputtime] => 1734572562 [_updatetime] => 1734572562 [_nrjc] => [_nrsh] => )
推荐意见
如果必须进行血栓预防时，应根据非心脏手术类型、卧床时间以及患者相关因素选择预防血栓药物的类型和治疗时间（低分子肝素、非维生素K口服抗凝剂或磺达肝癸钠）（证据级别：A；推荐强度：I）

If thromboprophylaxis is deemed necessary, it is recommended to choose the type and duration of thromboprophylaxis (LMWH, NOAC, or fondaparinux) according to type of NCS, duration of immobilization, and patient-related factors.(Evidence: Level A ，Recommendation: Class I)

证据评价方法：LOE

指南质量等级：A

年份：2022

国家：the European Society of Anaesthesiology and Intens

来源 2022 ESC Guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery
原文链接
阅读
Array ( [id] => 2165 [catid] => 311 [title] => 2022 ESC Guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery [thumb] => [keywords] => [description] => [hits] => [uid] => 3 [author] => 甘肃中医院 [status] => 9 [url] => https://www.anes-guide.com/show/2165.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.116 [inputtime] => 2024-12-19 09:42:42 [updatetime] => 2024-12-19 09:42:42 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 0 [wailian] => https://pubmed.ncbi.nlm.nih.gov/36017553/ [demo_url] => [zjpjff] => LOE [zjfj] => [tjqd] => [nianfen] => 2022 [guojia] => the European Society of Anaesthesiology and Intens [pdf] => [tjyjyw] => [lyyw] => In patients with a low bleeding risk, peri-operative thromboprophylaxis should be considered for a duration of up to 14 or 35 days, for total knee or hip arthroplasty, respectively.（IIa A) [laiyuan] => 低出血风险患者行全膝关节或全髋关节手术时应分别给予 14 d 或 35 d的围术期血栓预防。（证据级别：A；推荐强度：IIa） [znzldj] => A [_inputtime] => 1734572562 [_updatetime] => 1734572562 [_nrjc] => [_nrsh] => )
推荐意见
低出血风险患者行全膝关节或全髋关节手术时应分别给予 14 d 或 35 d的围术期血栓预防。（证据级别：A；推荐强度：IIa）

In patients with a low bleeding risk, peri-operative thromboprophylaxis should be considered for a duration of up to 14 or 35 days, for total knee or hip arthroplasty, respectively.（IIa A)

证据评价方法：LOE

指南质量等级：A

年份：2022

国家：the European Society of Anaesthesiology and Intens

来源 2022 ESC Guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery
原文链接
阅读
Array ( [id] => 2166 [catid] => 311 [title] => 2022 ESC Guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery [thumb] => [keywords] => [description] => [hits] => [uid] => 3 [author] => 甘肃中医院 [status] => 9 [url] => https://www.anes-guide.com/show/2166.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.116 [inputtime] => 2024-12-19 09:42:42 [updatetime] => 2024-12-19 09:42:42 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 0 [wailian] => https://pubmed.ncbi.nlm.nih.gov/36017553/ [demo_url] => [zjpjff] => LOE [zjfj] => [tjqd] => [nianfen] => 2022 [guojia] => the European Society of Anaesthesiology and Intens [pdf] => [tjyjyw] => [lyyw] => NOACs in thromboprophylaxis dose may be considered as alternative treatments to LMWH after total knee and hip arthroplasty.(Evidence: Level A，Recommendation: Class IIb ) [laiyuan] => 全膝关节和全髋关节置换术后，可使用非维生素K口服抗凝剂替代低分子肝素进行血栓预防。（证据级别：A；推荐强度：IIb） [znzldj] => A [_inputtime] => 1734572562 [_updatetime] => 1734572562 [_nrjc] => [_nrsh] => )
推荐意见
全膝关节和全髋关节置换术后，可使用非维生素K口服抗凝剂替代低分子肝素进行血栓预防。（证据级别：A；推荐强度：IIb）

NOACs in thromboprophylaxis dose may be considered as alternative treatments to LMWH after total knee and hip arthroplasty.(Evidence: Level A，Recommendation: Class IIb )

证据评价方法：LOE

指南质量等级：A

年份：2022

国家：the European Society of Anaesthesiology and Intens

来源 2022 ESC Guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery
原文链接
阅读

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