论文部分内容阅读
近年来,越来越多接受心脏植入电子装置(CIED)患者围手术期需要抗凝(AC)和/或抗血小板(AP)治疗。目前指南多推荐血栓中高危患者围手术期采用肝素桥接策略(HBS),但临床观察及荟萃分析显示HBS导致出血风险显著增加,而不中断口服抗凝疗法并不增加血栓事件发生率;双联AP与单联AP相比,前者明显增加术后出血风险。因此,围手术期对接受CIED植入的易栓患者应选择口服AC疗法或单联AP疗法的方案。
In recent years, more and more patients undergoing ICED require perioperative anticoagulation (AC) and / or antiplatelet (AP) treatment. Currently, guidelines recommend the use of heparin bridging strategy (HBS) perioperatively in high-risk patients with thrombosis. However, clinical observation and meta-analysis showed that the risk of bleeding increased significantly with HBS without increasing the incidence of thrombotic events without interruption of oral anticoagulant therapy. AP compared with the single AP, the former significantly increased postoperative bleeding risk. Therefore, the perioperative period of CIED implantation of the easy-to-embolism patients should choose oral AC therapy or single AP regimen.