基于美国胸科医师学会抗栓指南思考的抗血栓药物围手术期管理

Perioperative management of antithrombotic drugs:antithrombotic thinking based on American College of Chest Physicians guidelines

2022年美国胸科医师学会(American College of Chest Physicians,ACCP)发布抗栓治疗的围手术期管理指南。该指南主要针对4种临床情况提出抗栓建议,分别是接受维生素K拮抗剂、肝素(heparin)桥接、直接口服抗凝药物及抗血小板药物这4类药物需要手术或侵入性操作患者以及围手术期实验室检测提供指导建议。该文就ACCP围手术期抗栓治疗既往版本指南进行比较,同时结合国内发布的《抗栓治疗病人接受非心脏手术围手术期管理上海专家共识(2021版)》和《中国血栓性疾病防治指南》对该指南进行全面解读,以期为临床围手术期应用抗血栓药物提供参考。

In 2022,the American College of Chest Physicians(ACCP)released the guidelines for the perioperative management of antithrombotic therapy.The guidelines mainly put forward antithrombotic recommendations for four clinical situations.Patients receiving vitamin K antagonists,heparin bridging,direct oral anticoagulants,antiplatelet drugs requiring surgery or invasive procedures,and perioperative laboratory testing were advised.This article compared with previous versions of the ACCP guidelines for perioperative antithrombotic therapy,and made a comprehensive interpretation of the guidelines combined with Shanghai Expert Consensus On Perioperative Management of Antithrombotic Patients Accepting Non-Cardiac Surgery(2021 Edition)and Chinese Guidelines for the Prevention and Treatment of Thrombotic Diseases,in order to provide references for the clinical application of antithrombotic drugs in perioperative period.