论文部分内容阅读
人工永久起搏器围术期如何应用抗凝、抗栓药物，采取哪种策略使患者最大程度受益，目前仍存在较大争议。继续服用抗凝、抗栓药物会增加出血的风险，而停止应用可能会招致血栓等严重并发症。当前指南推荐对高危血栓患者围术期停口服药物，应用肝素替代，对于中、低危患者建议继续应用；而晚近荟萃分析发现围术期中断抗凝、抗栓药物应用肝素替代出血风险明显增加，继续口服抗凝、抗栓药物可能是更好的选择。“,”There is still much controversy about how to use the method of anticoagulation and anti-throm-bosis,which strategy to adopt to maximize the patients′benefits. Maintaining anticoagulant/platelet increases the risk of bleeding complications,whereas discontinuing may increase the risk of thromboembolic complica-tions. The current guidelines recommend that heparin replacement adopted for patients with high risk of thrombosis in the perioperative period of oral medication,for the middle and low risk patients are advised to continue the application;in recent years meta-analysis found that perioperative usage of heparin instead of anticoagulant and antithrombotic drugs significantly increased risk of hemorrhage, therefore oral uptake of anticoagulant and antithrombotic drugs may be a better choice.