| 422 | 0 | 33 |
| 下载次数 | 被引频次 | 阅读次数 |
目的规范华法林相关脑出血的救治措施和重启抗凝的策略。方法回顾1例华法林相关脑出血患者的救治经过,讨论其治疗方案及重启抗凝策略。结果通过给予维生素K1和凝血酶原复合物,遏制脑内血肿扩大,并在脑出血后第14天重启抗凝治疗,未发生再出血。结论紧急逆转华法林的抗凝作用是减少脑出血后血肿扩大的重要措施。口服抗凝药物相关脑出血停药2周,排除再出血风险,重启抗凝治疗是安全的。
Abstract：[1] HART R G,PEARCE L A,AGUILAR M I.Meta-analysis:antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation[J].Ann Intern Med,2007,146(12):857.
[2] HERMANS H,VANASSCHE T,HERIJGERS P,et al.Antithrombotic therapy in patients with heart valve prostheses[J].Cardiol Rev,2013,21(1):27.
[3] 刘鸣,蒋小群,游潮.应当重视脑出血的病因研究与规范化病因诊断[J].中华神经科杂志,2013,46(6):361.
[4] AGUILAR M I,HART R G,KASE C S,et al.Treatment of warfarin-associated intracerebral hemorrhage:literature review and expert opinion[J].Mayo Clin Proc,2007,82(1):82.
[5] FRONTERA J A,LEWIN III J J,RABINSTEIN A A,et al.Guideline for reversal of antithrombotics in intracranial hemorrhage:a statement for Healthcare Professionals from the Neurocritical Care Society and Society of Critical Care Medicine[J].Neurocrit Care,2016,24(1):6.
[6] 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.
[7] 梁迎芝,石际俊,徐加平,等.华法林相关脑出血3例报告及文献复习[J].中国临床神经科学,2015,23(4):384.
[8] TOMASELLI G F,MAHAFFEY K W,CUKER A,et al.2017 ACC expert consensus decision pathway on management of bleeding in patients on oral anticoagulants:a report of the American College of Cardiology Task Force on Expert Consensus Decision Pathways[J].J Am Coll Cardiol,2017,70(24):3042.
[9] WONG Y.Use of prothrombin complex concentrate for vitamin K antagonist reversal before surgical treatment of intracranial hemorrhag[J].Clin Med Insights Case Rep,2011,4:1.
[10] NUTESCU E A,DAGER W E,KALUS J S,et al.Management of bleeding and reversal strategies for oral anticoagulants:clinical practice considerations[J].Am J Health-Syst Pharm,2013,70(21):1914.
[11] da SILVA I R F,FRONTERA J A.Resumption of anticoagulation after intracranial hemorrhage[J].Curr Treat Options Neurol,2017,19(11):39.
基本信息:
DOI：10.19577/j.1007-4406.2020.01.015
中图分类号:R969
引用信息:
[1]季闽春,黄力鸥,宋锦飞.1例华法林相关脑出血患者的救治及重启抗凝策略[J].中国临床药学杂志,2020,29(01):63-66.DOI:10.19577/j.1007-4406.2020.01.015.
基金信息:
上海市临床药学重点专科建设项目(区属)(编号2018YXZDZK); 复旦大学附属上海市第五人民医院院级重点专科建设项目(编号2017WYZDEK06)
2020-01-25
2020-01-25