冠状动脉药物洗脱支架植入术后限期行非心脏手术围手术期抗血小板治疗研究进展

Perioperative Antiplatelet Therapy in Non-Cardiac Surgery within A Limited Period After Coronary Drug-Eluting Stent Implantation

心脏支架植入术后常规服用双重抗血小板药是预防术后血栓并发症的基石,同时能有效减少心血管事件的发生,在此期间部分患者需限期行非心脏手术。为寻求其缺血和出血风险达到最佳平衡,现临床上针对此围手术期抗血小板治疗的策略仍有争议。现就冠状动脉药物洗脱支架植入术后限期行非心脏手术围手术期抗血小板治疗是否需停用和桥接及对应桥接方案的应用及进展做一综述。

Routine use of dual antiplatelet drugs after cardiac stenting is the cornerstone of preventing postoperative thrombosis complications,and can effectively reduce the occurrence of cardiovascular events,during which some patients need to undergo non-cardiac surgery within a limited period.In order to achieve the optimal balance between perioperative ischemia and bleeding risk in these patients,the decision of perioperative antiplatelet therapy is still controversial.This article reviews the application and progress of perioperative antiplatelet discontinuation and bridging in non-cardiac surgery within a limited period after coronary drug-eluting stent implantation.