Kovich Olympia, Otley Clark C
Division of Dermatologic Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA.
Dermatol Surg. 2002 Jun;28(6):513-7. doi: 10.1046/j.1524-4725.2002.12109.x.
Perioperative management of therapy with anticoagulants or platelet inhibitors for patients having cutaneous surgery presents dilemmas for dermatologic surgeons.
To outline the current spectrum of practice for perioperative management.
Questionnaires were mailed to 504 dermatologic surgeons. Data included use of warfarin, aspirin, and nonsteroidal anti-inflammatory drugs (NSAIDs) perioperatively and involvement of other physicians in making management decisions.
Of the responding physicians, 83% routinely ask primary physicians or cardiologists for recommendations about perioperative management, 80% discontinue warfarin therapy perioperatively at least some of the time, 26% always discontinue aspirin therapy, 38% manage aspirin and NSAIDs in the same manner, and 53% withhold therapy with NSAIDs for less time than with aspirin.
Dermatologic surgeons use various perioperative management strategies. Despite no published evidence of increased hemorrhagic risk with anticoagulant or platelet inhibitor therapy during cutaneous surgery, many physicians discontinue therapy perioperatively.
对于接受皮肤外科手术的患者，围手术期抗凝剂或血小板抑制剂治疗的管理给皮肤科外科医生带来了难题。
概述围手术期管理的当前实践范围。
向504名皮肤科外科医生邮寄问卷。数据包括围手术期华法林、阿司匹林和非甾体抗炎药（NSAIDs）的使用情况以及其他医生参与管理决策的情况。
在回复的医生中，83%会常规向初级医生或心脏病专家询问围手术期管理的建议，80%至少在某些时候会在围手术期停用华法林治疗，26%总是停用阿司匹林治疗，38%以相同方式管理阿司匹林和NSAIDs，53%停用NSAIDs治疗的时间比停用阿司匹林的时间短。
皮肤科外科医生使用各种围手术期管理策略。尽管没有已发表的证据表明皮肤外科手术期间抗凝剂或血小板抑制剂治疗会增加出血风险，但许多医生仍在围手术期停用治疗。
