冠状动脉支架置入术后抗血小板治疗和出血风险的综合考量

Risk of Bleeding and Antiplatelet Therapy for the Patients After Coronary Stent Implantation

冠状动脉支架置入术后强化抗血小板治疗可预防支架内血栓形成，置入药物洗脱支架的患者，至少双联抗血小板治疗12个月。但长期的双联抗血小板治疗给患者带来获益的同时也增加了出血风险，因此应根据支架内血栓形成危险分层和出血风险进行综合考量，采取个体化的治疗策略，并加强对患者药学监护、用药宣教和随访管理。在治疗过程中及时发现不良事件及潜在问题，并权衡利弊后处理，保障患者长期抗血小板治疗的安全有效。

Antiplatelet therapy can prevent stent thrombosis for the patients after coronary stent implantation. And for the patients receiving drug - eluting stent dual antiplatelet therapy （DAT） should be lasted for at least 12 months. But long - term DAT not only brings benefits to those patients, but also increases risk of bleeding. Stent thrombosis risk stratification and the risk of bleeding should be considered in order to take individualized therapeutic measures. Therefore pharmaceutical care, patients education and follow - up management for those patients should also be enhanced. During the treatment adverse events and potential troubles must be found out in time and be resolved according to weighting to the advantages and disadvantages to ensure the safty and efficiency for the patients receiving long - term antiplatelet therapy.