在神经外科干预之前停用阿司匹林:一个有争议的问题
Alexander Kulikov1, Anton Konovalov2, Pier Paolo Pugnaloni3
1Department of Anesthesiology, Burdenko National Medical Research Center of Neurosurgery, Moscow 125047, Russia.
慢性阿司匹林使用可能不需要在神经外科手术前中断,这挑战了当前的指导方针. 这篇评论考察了阿司匹林.
科学领域:
- 神经外科 神经外科
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 阿司匹林是常见的预防缺血事件.
- 长期使用阿司匹林可能会增加手术出血的风险.
- 神经外科指南建议在治疗前7天停止服用阿司匹林,因为缺乏确的证据.
研究的目的:
- 审查挑战神经外科手术前阿司匹林中断必要性的证据.
- 讨论阿司匹林效果监测及其临床影响.
- 总结阿司匹林使用者接受神经外科手术的出血风险数据.
主要方法:
- 现有文献的叙述性审查.
- 对神经外科患者阿司匹林和出血的临床数据的分析.
- 对阿司匹林效果监测技术的评估.
主要成果:
- 有证据表明,对所有神经外科患者来说,可能不需要停止服用阿司匹林.
- 阿司匹林效果监测提供了管理术后风险的选择.
- 在不同的神经外科手术程序 (脑瘤,脑血管,脊髓) 中,出血风险各不相同.
结论:
- 当前关于在神经外科手术前停用阿司匹林的指导方针可能过于谨慎.
- 基于阿司匹林效果监测和程序类型的个性化管理是合理的.
- 需要进一步的研究来完善在神经外科手术中使用阿司匹林的建议.
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