歲月麻醉

Anesthesia,Joyful Life
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術前抗凝劑是否停用

http://n.yam.com/cht_health/healthy/201104/20110427217674.html

一位曾安裝過心臟支架的患者，因為臨時急需拔牙，擔心正在服用的抗血栓藥物會造成血液無法凝結而血流不止，因此自行停藥多日，沒想到不到一週便出現血栓問題。安裝塗藥支架病患必需搭配抗血栓藥物至少一年以上，但有許多患者會因各種理由擅自停藥，增加死亡風險。
 以外科醫師的立場，當然是停藥，主要是考慮到流血的風險（量，及機率），不過這種憂慮是主觀的，目前只有承認在神經外科以及攝護腺手術有此這樣的風險，其餘血栓的風險大部分大於出血的風險，因此不需停藥的機會遠大於需要停藥的建議，且醫師應該知會病患，讓其理解出血與血栓各自的 risk vs. benefit 考量，最後由病人決定是否開刀。

Heart Lung Circ. 2011 Apr 13.
Focused Clinical Review: Periprocedural Management of Antiplatelet Therapy in Patients with Coronary Stents.

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2011年5月1日 星期日 at 下午2:44

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