之前的冠状动脉支架不排除主要的肺切除,无论抗血小板治疗
Isamu Watanabe1, Aritoshi Hattori1, Mariko Fukui1
1Department of General Thoracic Surgery, Juntendo University School of Medicine, 1-3 Hongo 3-Chome, Bunkyo-Ku, Tokyo, 113-8431, Japan.
Surgery today
|September 8, 2024
概括
对于用冠状动脉支架进行肺切除的患者,停止抗血小板治疗是安全的. 较新的药物释放支架可以降低风险,使药物停用成为合理的选择.
科学领域:
- 心脏病学 心脏病学
- 胸部外科手术 胸部外科手术
- 在瘤学瘤学.
背景情况:
- 管理正在接受肺切除的冠状动脉支架患者需要仔细考虑抗血小板治疗.
- 术后抗血小板治疗策略各不相同,影响患者的治疗结果.
研究的目的:
- 评估一般胸部外科手术在患者之前冠状动脉支架进行肺切除的安全性.
- 评估不同抗血小板治疗管理策略对术后结果的影响.
主要方法:
- 对150名冠状动脉支架患者进行肺切除的回顾性研究 (2009年7月至2018年7月).
- 在三个组中对术前结果 (主要心脏和脑血管不良事件) 的比较:停止抗血小板治疗,肝素桥接和持续抗血小板治疗.
- 分析包括血液损失,输血率,手术持续时间和不良事件.
主要成果:
- 两组之间没有观察到血液损失,输血率或手术持续时间的显著差异.
- 主要不良心脏和脑血管事件发生在2.7%的患者中,在各组中发生的比例相似.
- 持续抗血小板治疗的患者中有4.7%发生严重出血.
结论:
- 在冠状动脉支架患者中,肺切除是可行的,无论抗血小板治疗管理如何.
- 停止双抗血小板或单抗血小板治疗可能是合理的,因为现代药物排泄支架的高安全性.
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