抗凝治疗的围术期桥接管理

Bridging Management of Antithrombotic Therapy in Patients Undergoing Invasive Procedures

随着心房颤动、机械瓣换瓣术后、静脉血栓、冠状动脉支架术后长期接受抗凝、双联抗血小板治疗的患者人群急剧增加,其接受外科或其他侵入性操作期间是否需要短期停用抗栓治疗尚存争议。现回顾对于那些接受抗栓及新型抗栓药物治疗的患者行有创操作前相关指南的新进展及推荐,以最大程度降低血栓栓塞风险同时降低围术期出血风险为目的来指导临床实践工作。

As the occurrence rate rising dramatically on the patients with atrial fibrillation, mechanical valve after valve surgery, ve- nous thrombosis, coronary stenting accompany with long-term antieoagulation treatment and dual antiplatelet therapy, there are disputes on their therapies whether a short-term antithrombotic therapy should be disabled before any surgical or other invasive procedures. This article reviews the latest development and recommendation on the guidelines for invasive procedures on those patients receiving antithrombotic and new antithrombotic drug therapy in order to minimize the risk of thromboembolism, and also to reduce the risk of perioperative bleeding in clinical practice.