Inhloso
Inhloso bekuwukwethula ngempumelelo nangokucophelela iqembu elisha lama-anticoagulant (Idatha ye-NOAC) ukuvimbela unhlangothi (i-cerebral infarction) ezigulini ezine-atrial fibrillation (uhlobo lwe-arrhythmia lapho inhliziyo ishaya khona ngokungajwayelekile futhi ngokuvamile ngokushesha), ukuze ukungaqiniseki mayelana nokuphepha kokusetshenziswa kwalezi zinto ekusebenzeni kwansuku zonke kungasuswa. Kuphinde kwaba nesidingo sokuphenya ukusebenza ngempumelelo kwezindleko zale mithi uma kuqhathaniswa nokwelashwa 'okukhona' kwe-anticoagulant ye-atrial fibrillation e-Netherlands kusetshenziswa izimbangi zikavithamini K ezinokuhlolwa kwe-INR okuhlobene ngesevisi ye-thrombosis..
Indlela yokwenza
Ngesikhathi sokwethulwa kwe-NOACs yokuvimbela isifo sohlangothi ezigulini ezine-non-valvular atrial fibrillation. (I-NVAF) eNetherlands ekugcineni 2012 Ngesicelo soMnyango Wezempilo, kwadwetshwa umhlahlandlela oneseluleko mayelana nokwethulwa kancane kancane nangokuphephile kwama-NOAC.. Izizathu eziyinhloko zalokhu kwakuyinhlangano engcono yokunakekelwa kwe-thrombosis ezweni lethu uma kuqhathaniswa namanye amazwe aseNtshonalanga kanye nezindleko eziphakeme zokwelashwa nge-NOAC.. Lesi siqondiso sakhiwe ngabamele izinhlangano zesayensi ezihilelekile ngokuqondile (I-NVVC, I-NIV, I-NVN, NOV, I-VAL/NVKC, I-NVZA/KNMP). Ukubaluleka kokulandela isiqondiso nokuqinisekisa isingeniso esicophelelayo kwagcizelelwa ibhodi le-Dutch Cardiology Association ngaleso sikhathi.. kwaba futhi, ngesicelo sikahulumeni, sekusungulwe ikhomishana yophenyo ukuze yenze ucwaningo oluceliwe mayelana nokuphepha kanye nokusebenza ngempumelelo kwezindleko zalawa ma-ejenti ekusebenzeni kwansuku zonke.. Kuze kube manje, ekuqaleni kwenziwa ucwaningo lokuhlola ngedathabheyisi yezicelo ze-VEKTIS (imininingwane enomshwalense), lapho iziguli ezelashwa nge-oral anticoagulation zenkomba ye-NVAF zihlonzwe. Le datha efakwe kumshwalense ivele yanganele (isiguli)ziqukethe ulwazi ukuze zikwazi ukuphendula imibuzo ebuziwe. Kwabe sekwenziwa ucwaningo olusha ukuze kuqoqwe idatha eyengeziwe ehlobene nesiguli emisebenzini yansuku zonke. ingxenye kaFebhuwari 2016 wuhlelo oluqondile kwa-ZonMw 'lokubhaliswa kuzwelonke kwe-anticoagulation ye-NVAF': I-Dutch AF Registry' kanye nale phrojekthi ebanzi kulindeleke ukuthi iqale kulo nyaka.
Umphumela
Ngokuphambuka kwezinye izethulo, kungahlongozwa ukuhlelwa komhlahlandlela kanye nocwaningo olwengeziwe, ethize esimeni samaDashi. Ukungaqiniseki nezingxoxo ezaqubula lokhu kwaholela kokuningi (ngokwengxenye kungenasidingo futhi kungenasisekelo) ukusakazwa okungekuhle kuma-NOAC nezingxoxo phakathi kwabasebenzi (odokotela benhliziyo, abafundisi, izazi zezinzwa, odokotela abajwayelekile kanye nesevisi ye-thrombosis). Kuholele ekusungulweni kwemakethe okuhamba kancane kunalokho obekulindelwe, lapho kungebona abakhiqizi bama-NOAC kuphela kodwa nezinhlangano zesiguli ezinganelisekile: Siphi isiguli uqobo lwakhe kule ndaba?
Izifundo
Amaqembu amaningi abambe iqhaza ekwethulweni kwama-NOAC, ngokwengxenye izithakazelo ezingqubuzanayo. Intshisekelo yesiguli yafiphala ngandlela thize ngemuva kulo mkhakha wokushuba kwesimo, kuyilapho lokhu bekufanele kube isisekelo esiqhubekayo sokwethulwa ngokucophelela ngaphansi kwesibopho esihlanganyelwe samaqembu ahlukahlukene. Lokhu cishe bekungabangela ukuxokozela okuncane futhi bekungase kuphendule imibuzo mayelana nokuphepha nokusebenza kahle kwezindleko kwama-NOAC ngokushesha., ethize esimeni samaDashi. Hans van Laarhoven (omele inhlangano yeziguli uHart&iqembu le-vascular) esho kamnandi kanje: "Lokho kungaphikisana nenqubo yokungeniswa komphakathi jikelele."
