Expert consensus on clinical application of parenteral direct thrombin inhibitors in perioperative period
- VernacularTitle:围手术期应用胃肠外直接凝血酶抑制剂的专家共识
- Author:
Mingyu JIANG
1
;
Yuan BIAN
2
;
Lizhu HAN
2
;
Qinan YIN
2
;
Fengjiao KANG
3
;
Anhua WEI
4
;
Danjie ZHAO
5
;
Lin WANG
6
;
Ying SHAO
7
;
Li TANG
8
;
Yi WANG
9
;
Shuhong LIANG
10
;
Huijuan LIU
11
;
Guirong XIAO
12
;
Yue LI
13
Author Information
1. Dept. of Pharmacy/Personalized Drug Research and Therapy Key Laboratory of Sichuan Province，Sichuan Academy of Medical Science & Sichuan Provincial People’s Hospital （the Affiliated Hospital of UESTC），Chengdu 610072，China;School of Pharmacy，North Sichuan Medical College，Sichuan Nanchong 637000，China
2. Dept. of Pharmacy/Personalized Drug Research and Therapy Key Laboratory of Sichuan Province，Sichuan Academy of Medical Science & Sichuan Provincial People’s Hospital （the Affiliated Hospital of UESTC），Chengdu 610072，China
3. School of Medicine，University of Electronic Science and Technology of China，Chengdu 610054，China;Dept. of Pharmacy，Affiliated Hospital of Traditional Chinese Medicine，Xinjiang Medical University，Urumqi 830054，China
4. Dept. of Pharmacy，Tongji Hospital，Tongji Medical College，Huazhong University of Science and Technology，Wuhan 430033，China
5. Dept. of Pharmacy，Chengdu Shuangliu District First People’s Hospital （West China Airport Hospital of Sichuan University），Chengdu 610200，China
6. Dept. of Δ 基金项目 四川省自然科学基金（No.2022NSFSC0818）
7. 四川省 Pharmacy，Chengdu Seventh People’s Hospital，医学科学院·四川省人民医院个体化药物治疗四川省重点实验室开放 Chengdu 610041，China
8. Dept. of Pharmacy，the 和自拟课题（No.2021ZD01） First Affiliated Hospital of Chengdu Medical College，第一作者 药师，硕士研究生 。研究方向 ：药理学 。E-mail： Chengdu 610500，China
9. Dept. of Pharmacy，the 1255622143@qq.com # 通信作者 主任药师，副教授，硕士生导师。研究方向：临床药 Fourth People’s Hospital of Sichuan Province，学。E-mail：85778860@qq.com Chengdu 610066，China
10. Dept. of Pharmacy，the 中国药房 2026年第37卷第6期 China Pharmacy 2026 Vol. 37 No. 6 · 689 · Fifth People’s Hospital of Sichuan Province，Chengdu 611130，China
11. Dept. of Pharmacy，the First Affiliated Hospital of Zhengzhou University，Zhengzhou 450052，China
12. Dept. of Pharmacy，363 Hospital，Chengdu 610097，China
13. Dept. of Pharmacy，West China Hospital，Sichuan University，Chengdu 610041，China
- Publication Type:Journal Article
- Keywords:
parenteral direct thrombin inhibitors;
perioperative period;
anticoagulation;
thromboembolism;
rational drug use
- From:
China Pharmacy
2026;37(6):689-699
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To form an expert consensus on the clinical application of parenteral direct thrombin inhibitors （DTIs） in patients during the perioperative period. METHODS Led by Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital （the Affiliated Hospital of UESTC）， a multidisciplinary working group was established. Through literature review and the Delphi method， clinical questions related to the rational perioperative use of parenteral DTIs were identified. A structured design was adopted using the “Population-Intervention-Comparison-Outcome” framework； systematic searches were conducted in CNKI， Medline， Embase and other databases. Relevant evidence from randomized controlled trials and cohort studies was included and synthesized. Evidence quality was assessed using the Grades of Recommendations Assessment，Development and Evaluation （GRADE） approach， and recommendations were formulated through multiple rounds of Delphi surveys and expert consensus meetings. RESULTS &CONCLUSIONS Seven recommendations （each with an expert consensus rate exceeding 90%） on the use of parenteral DTIs in perioperative patients were developed. These recommendations specify drug selection， dosing ranges， key monitoring points， and safety management strategies for parenteral DTIs in various scenarios， including the perioperative period of ventricular assist device implantation， the perioperative period of cardiac surgery， perioperative patients with lower-extremity atherosclerotic disease， the perioperative period of percutaneous coronary intervention in patients with acute coronary syndrome， the perioperative period of carotid artery stenting in patients with carotid stenosis， the perioperative period of patients with right heart thrombosis， and patients who develop related thrombosis and dysfunction after a central venous catheter insertion. In addition， warning and management pathways for perioperative bleeding and thrombotic events were proposed. This expert consensus， which is formulated based on the best available evidence， provides evidence-based guidance for standardized and individualized use of parenteral DTIs in perioperative period.
