[1]刘彬彬、卢玉昭,岳建人、曹成龙、马　盼,徐国政、宋　健.长期接受抗凝抗聚药物治疗病人并发脑出血的治疗分析[J].中国临床神经外科杂志,2019,(07):416-418.[doi:10.13798/j.issn.1009-153X.2019.07.011]
　LIU Bin-bin,LU Yu-zhao,YUE Jian-ren,et al.Treatment of long-term anticoagulation and antiaggregation-related cerebral hemorrhage: single center experience in 33 cases[J].,2019,(07):416-418.[doi:10.13798/j.issn.1009-153X.2019.07.011]
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长期接受抗凝抗聚药物治疗病人并发脑出血的治疗分析()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2019年07期
页码:
416-418
栏目:
论著
出版日期:
2019-07-25

文章信息/Info

Title:
Treatment of long-term anticoagulation and antiaggregation-related cerebral hemorrhage: single center experience in 33 cases
文章编号:
10.13798/j.issn.1009-153X.2019.07.011
作者:
刘彬彬、卢玉昭；岳建人、曹成龙、马　盼；徐国政、宋　健
430065 武汉，武汉科技大学医学院（刘彬彬、卢玉昭）；510515 广州，南方医科大学研究生院（岳建人、曹成龙、马　盼）；430070 武汉，中国人民解放军中部战区总医院神经外科（徐国政、宋　健）
Author(s):
LIU Bin-bin1;  LU Yu-zhao1;  YUE Jian-ren2;  CAO Cheng-long2;  MA Pan2;  XU Guo-zheng3;  SONG jian3. 1. Medical School;  Wuhan University of Sciences and Technology;  Wuhan 430070;  China; 2. Graduate School;  Nanfang Medical University;  Guangzhou 510515;  China; 3. Department of Neurosurgery;  General Hospital;  Central Theater;  PLA;  Wuhan 430070;  China
1. Medical School, Wuhan University of Sciences and Technology, Wuhan 430070, China; 2. Graduate School, Nanfang Medical University, Guangzhou 510515, China; 3. Department of Neurosurgery, General Hospital, Central Theater, PLA, Wuhan 430070, China
关键词:
脑出血; 凝血功能; 抗凝药物; 抗聚药物; 治疗
Keywords:
Anticoagulation;  Antiaggregation;  Cerebral hemorrhage;  Treatment
分类号:
R 743.34; R 651.1+2
DOI:
10.13798/j.issn.1009-153X.2019.07.011
文献标志码:
A
摘要:
目的 探讨长期接受抗凝抗聚药物治疗病人发生脑出血的治疗方法及疗效。方法 回顾性分析2014年8月至2018年8月收治的33例长期接受抗凝抗聚药物治疗的脑出血的临床资料。保守治疗10例，急诊开颅血肿清除+去骨瓣减压术7例，钻孔引流术16例。结果 术后死亡1例（3%）。32例平均随访6个月，依据日常生活能力量表：Ⅰ级2例，Ⅱ级11例，Ⅲ级12例，Ⅳ级5例，Ⅴ级2例。结论 对长期接受抗凝抗聚药物治疗的脑出血，应密切监测凝血功能及相关指标参数，根据病人的具体情况选择针对性的治疗措施。
Abstract:
Objective To summarize the clinical experience in treating the cerebral hemorrhage in patients who received long-term anticoagulation and antiaggregation therapy (LTAAT). Methods The clinical data of 33 consecutive patients with cerebral hemorrhage receiving LTAAT, who were treated in Department of Neurosurgery of General Hospital of Central Theater from August, 2014 to August, 2018, were analyzed retrospectively. Of these 33 patients, 10 were conservatively treated, 7 by removal of intracranial hematomas and skull bone flaps and 16 by skull drilling and drainage of intracranial hematomas. Results Of these 33 patients, 1 (3.0%) died, 2 (6.1%) belonged in the activities of daily living grade I, 11 (33.3%) in grade Ⅱ, 12 (36.4%) in grade Ⅲ, 5 (15.2%) in grade Ⅳ, and 2 (6.1%) in grade V. Conclusions The coagulation function and related indicators and parameters should be closely monitored in the patients with cerebral hemorrhage who have received LTAAT, and the methods directing against their specific conditions should are selected.

参考文献/References:

[1] 朱　勇，吕中华，陈　江. 软通道治疗抗凝或抗栓药物相 关性脑出血21例临床分析[J]. 浙江创伤外科，2018，23 （1）：120-122. [2] 印辰宇，马建华，季海明. 抗凝药物相关脑出血病人开颅 手术前处理策略[J]. 海峡药学，2015，27（11）：173-174. [3] 周玉利，周青雪，赵洪灿. 血栓弹力图应用于冠心病心律 不齐型的凝血监测[J]. 现代实用医学，2015，27（4）： 427-428. [4] De Pietri L, Bianchini M, Montalti R, et al. Thrombelasto- graphy-guided blood product use before invasive proce- dures in cirrhosis with severe coagulopathy: a randomized, controlled trial [J]. Hepatology, 2016, 63(2): 566-573. [5] Schulman S, Gross PL, Ritchie B, et al. Prothrombin com- plex concentrate for major bleeding on factor xa inhibitors: a prospective cohort study [J]. Thromb Haemost, 2018, 118 (5): 842-851. [6] 黄　璠. 人凝血酶原复合物的制备及临床应用[J]. 临床医 药实践，2014，23（7）：529-532. [7] Abdoellakhan RA, Miah IP, Khorsand N, et al. Fixed versus variable dosing of prothrombin complex concentrate in vitamin K antagonist-related intracranial hemorrhage: a retrospective analysis [J]. Neurocrit Care, 2017, 26(1): 64- 69. [8] Steiner T, Poli S, Griebe M, et al. Fresh frozen plasma versus prothrombin complex concentrate in patients with intracra- nial haemorrhage related to vitamin K antagonists (INCH): a randomised trial [J]. Lancet Neurol, 2016, 15(6): 566-573. [9] 王广杰，金　娴，曹廷卉，等. 输注新鲜冰冻血浆病人血液 相关指标变化与疗效分析[J]. 检验医学与临床，2016，13 （22）：3214-3216. [10] 王建涛，阚志生. 华法林相关脑出血的临床特点及手术疗 效（附65例报告）[J]. 中华神经外科杂志，2017，33（2）： 164-168.

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备注/Memo

备注/Memo:
（2019-03-04收稿，2019-03-18修回）基金项目：国家自然科学基金（81571049；81400865） 通讯作者：宋　健，E-mail：sn413314@126.com
更新日期/Last Update: 2019-07-25