与故意停止侵入性手术的抗血栓治疗相关的中风风险
Nobuyuki Mitsui1, Manabu Kinoshita1, Jun Sawada2
11Department of Neurosurgery, Asahikawa Medical University.
Neurosurgical focus
|October 1, 2023
概括
在手术过程中停止抗血栓治疗会增加脑缺血事件的风险. 双重治疗的患者面临的风险明显更高,尽管整体风险仍然很低.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 临床医学 临床医学
背景情况:
- 抗血栓药物对于预防血栓事件至关重要,但使侵入性手术复杂化.
- 停止治疗是必要的,以减轻出血风险,但可能会增加缺血风险.
研究的目的:
- 量化需要在住院治疗过程中停止抗血栓治疗的患者中脑缺血事件的风险增加.
主要方法:
- 一个单一中心的回顾性观察研究.
- 从2021年1月1日至2022年12月31日期间入院的患者收集的数据.
- 识别停止服用抗血栓剂的患者和患有脑缺血的患者.
主要成果:
- 在接受手术的835名患者中,发生了2例脑性缺血 (0.24%的发病率).
- 这种发病率明显高于医院中风的偶发发病率 (p=0.04).
- 结合抗凝和抗血小板治疗的患者显示大脑缺血的风险明显更高 (p<0.0001).
结论:
- 选择性手术中断抗血栓治疗带来了小但统计学上显著的脑缺血风险增加.
- 在接受双重抗血栓治疗的患者中,风险明显更高.
- 虽然绝对风险很低,但对于需要停止抗血栓治疗的患者,需要仔细考虑.
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