老年患者使用新型口服抗凝药物治疗时需要注意的问题

Points needing attention in application of new oral anticoagulants in elderly patients

新型口服抗凝药物（NOACs）的问世，为静脉血栓栓塞症患者带来了治疗上的便利。但是，对于老年患者，由于基础疾病较多、可能同时服用多种药物等原因，在使用NOACs时需要注意一些问题，如脏器功能不全时的药物调整、如何实现抗凝药物之间的相互转换、进行有创性操作时抗凝药物的使用以及发生出血时的处理等。本文主要针对老年患者在使用NOACs时需要注意的一些问题进行阐述，以利于更加合理地使用NOACs并减少由于药物使用不当所造成的危害。

The development of new oral anticoagulants （NOACs） has brought more convenience in treatment of venous thromboembolism. However, with regard to the elderly, due to their co-existing comorbidities and multiple medication use, there are some points needing special attention in the use of NOACs, such as drug adjustment in the patients with organ dysfunctions, switch among different anticoagulants, use of anticoagulants in course of invasive manipulations, management during hemorrhages and so on. This article aimed to illustrate some points, to which attention should be paid in the use of NOACs in the elderly so as to obtain more rational NOACs use and reduce the damages caused the improper use.