在ST升高心肌梗塞患者的脊髓刺激器试验中进行抗凝管理
Laert Rusha1, Abhishek Yadav2, Justin Li1
1Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, RI.
Pain medicine case reports
|July 3, 2025
概括
在ST升高心肌梗塞 (STEMI) 患者中进行脊髓刺激器 (SCS) 试验的抗凝药管理需要仔细平衡出血和凝血风险. 这一案例凸显了在SCS植入后启动双重抗血小板治疗时需要个性化方案的必要性.
科学领域:
- 疼痛管理 疼痛管理
- 心脏病学 心脏病学
- 神经外科 神经外科
背景情况:
- 脊髓刺激器 (SCS) 用于慢性疼痛,通常涉及永久植入之前的试验期.
- 接受抗凝药的患者需要在SCS手术期间遵守特定的指导方针.
- 在接受SCS试验的患者中管理抗凝血具有独特的挑战.
研究的目的:
- 报告一个独特的病例,患者在SCS试验植入后经历ST升高心肌梗塞 (STEMI).
- 讨论最近接受SCS植入的STEMI患者的抗凝固管理策略.
- 突出SCS植入后双重抗血小板治疗的患者外周血液瘤的风险.
主要方法:
- 一份病例报告详细介绍了一项SCS试验,随后在植入后的第四天进行STEMI.
- 冠状动脉再血管和启动双抗血小板治疗.
- 在SCS试验删除之前,用静脉注射的抗血小板药物进行桥梁治疗.
主要成果:
- 患者在SCS试验植入后不久就发生了STEMI.
- 在STEMI后的双重抗血小板治疗造成了外周血液瘤的高风险.
- 成功的桥梁治疗允许安全的SCS试验移除和密切监控.
结论:
- 近期STEMI患者的SCS患者的抗凝固管理需要采用多学科的方法.
- 在这种患者群体中,桥梁治疗对于减轻在SCS试验移除期间出血风险至关重要.
- 密切监测是必要的,以防止并发症,如外周血腫.
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