Lub hom phiaj
Lub hom phiaj yog kom ua tiav thiab ua tib zoo qhia ib pab pawg tshiab ntawm cov tshuaj tiv thaiv coagulants (NOAC cov) rau kev tiv thaiv mob stroke (cerebral infarctions) Hauv cov neeg mob uas muaj atrial fibrillation (hom arrhythmia uas lub plawv dhia tsis xwm yeem thiab feem ntau nrawm dua), yog li ntawd qhov tsis paub meej txog kev nyab xeeb ntawm kev siv cov tshuaj no hauv kev xyaum txhua hnub tuaj yeem raug tshem tawm. Kuj tseem muaj qhov xav tau los tshawb xyuas qhov txiaj ntsig zoo ntawm cov neeg ua haujlwm no hauv kev sib piv nrog 'muaj' kev kho mob anticoagulant ntawm atrial fibrillation hauv Netherlands siv cov vitamin K antagonists nrog INR cov kev kuaj xyuas los ntawm kev pabcuam thrombosis..
Txoj kev mus kom ze
Thaum lub sijhawm qhia txog NOACs rau kev tiv thaiv mob stroke hauv cov neeg mob uas tsis yog-valvular atrial fibrillation (NVAF) hauv Netherlands thaum kawg 2012 Raws li kev thov los ntawm Ministry of Health, ib qho kev taw qhia tau kos nrog cov lus qhia txog kev maj mam thiab kev nyab xeeb ntawm NOACs. Cov laj thawj tseem ceeb ntawm qhov no yog lub koom haum zoo dua ntawm kev saib xyuas mob thrombosis hauv peb lub tebchaws piv rau lwm lub tebchaws sab hnub poob thiab tej zaum yuav raug nqi ntau dua ntawm kev kho mob nrog NOAC.. Cov lus qhia no tau kos los ntawm cov neeg sawv cev ntawm cov koom haum tshawb fawb ncaj qha (NVVC, NIV, NVN, NOV, VAL/NVKC, NWS/KNMP). Qhov tseem ceeb ntawm kev ua raws li cov lus qhia thiab ua kom muaj kev ua tib zoo qhia tau hais txog los ntawm pawg thawj coj ntawm Dutch Cardiology Association thaum lub sijhawm.. kuj yog, raws li kev thov ntawm tsoomfwv, Pawg neeg tshawb nrhiav tau raug tsim los ua qhov kev thov tshawb fawb txog kev nyab xeeb thiab kev ua tau zoo ntawm cov neeg ua haujlwm hauv kev xyaum txhua hnub. Txog qhov kawg no, kev tshawb nrhiav kev sim tau pib ua nrog VEKTIS cov ntaub ntawv thov (cov ntaub ntawv pov hwm), nyob rau hauv uas cov neeg mob kho nrog qhov ncauj anticoagulation rau qhov qhia tau hais tias NVAF. Cov ntaub ntawv pov hwm no tau pom tias tsis txaus (neeg mob)muaj cov ntaub ntawv kom muaj peev xwm teb cov lus nug. Ib txoj kev tshawb nrhiav tshiab tau tsim los sau cov ntaub ntawv ntsig txog tus neeg mob ntau dua los ntawm kev xyaum ua txhua hnub. ib nrab lub Ob Hlis 2016 yog lub hom phiaj tseem ceeb ntawm ZonMw rau 'National sau npe ntawm anticoagulation rau NVAF': Dutch AF Registry' thiab qhov kev nthuav dav no yuav tsum pib xyoo no.
Qhov tshwm sim
Deviating los ntawm lwm yam kev taw qhia, kev tsim qauv ntawm cov lus qhia thiab kev tshawb fawb ntxiv tuaj yeem raug npaj, tshwj xeeb rau qhov xwm txheej Dutch. Qhov tsis paub meej thiab kev sib tham uas qhov no ua rau muaj ntau yam (ib feem tsis tsim nyog thiab tsis ncaj ncees) Kev tshaj tawm tsis zoo nyob ib puag ncig NOACs thiab kev sib tham ntawm cov kws tshaj lij (kws kho plawv, internists, kws kho mob hlwb, Cov kws kho mob dav dav thiab kev pabcuam thrombosis). Nws ua rau kev lag luam qeeb qeeb tshaj li qhov xav tau, qhov twg tsis yog cov tuam txhab tsim khoom ntawm NOACs nkaus xwb tab sis kuj koom nrog cov neeg mob tsis txaus siab: Tus neeg mob nws tus kheej nyob qhov twg hauv zaj dab neeg no?
Cov lus qhia
Ntau tog tau koom nrog hauv kev qhia txog NOACs, ib feem nrog kev tsis sib haum xeeb. Qhov kev txaus siab ntawm tus neeg mob faded me ntsis mus rau hauv keeb kwm yav dhau nyob rau hauv daim teb no ntawm nro, thaum qhov no yuav tsum tau tsim lub hauv paus txuas ntxiv rau kev ua tib zoo qhia nyob rau hauv lub luag haujlwm sib koom ua ke ntawm ntau lub tog. Qhov no feem ntau yuav ua rau muaj kev ntxhov siab tsawg dua thiab tuaj yeem teb cov lus nug txog kev nyab xeeb thiab kev ua tau zoo ntawm NOACs sai dua., tshwj xeeb rau qhov xwm txheej Dutch. Hans van Laarhoven (tus neeg sawv cev ntawm tus neeg mob koom haum Hart&Barrel pawg) hais qhov no zoo nkauj: "Qhov ntawd yuav sib cav rau cov txheej txheem kev qhia pej xeem dav dav."
