神经轴索麻醉的风险与并发症以及外科手术患者抗凝治疗的应用
Risks and complications of neuraxial anesthesia and the use of anticoagulation in the surgical patient.
作者信息
Allen Douglas J, Chae-Kim Sang H, Trousdale Devin M
机构信息
Department of Anesthesiology and Pain Management, Baylor University Medical Center, Dallas, Texas 75246, USA.
出版信息
Proc (Bayl Univ Med Cent). 2002 Oct;15(4):369-73. doi: 10.1080/08998280.2002.11927867.
Abstract
Recognition of the risk of thromboembolic phenomena to patients in the postsurgical period has resulted in the practice of administering prophylactic anticoagulant agents to those patients who are at high risk for this complication. Institution of a perioperative anticoagulant or antithrombotic protocol needs to be considered when a regional anesthetic is proposed as part of, or as the total, anesthetic management of the patient. This article reviews current data on the risks involved in the use of neuraxial regional anesthesia in the care of surgical patients in whom prophylactic thromboembolic anticoagulant therapy is planned. Guidelines are established to help the physician minimize the risks of a neuraxial hematoma forming, monitor the patient for this complication, and optimally treat him or her if a hematoma were to occur.
摘要
认识到术后患者发生血栓栓塞现象的风险后，人们开始对有此并发症高风险的患者采取预防性抗凝剂给药措施。当提议将区域麻醉作为患者麻醉管理的一部分或全部时，需要考虑制定围手术期抗凝或抗血栓方案。本文综述了目前有关计划进行预防性血栓栓塞抗凝治疗的外科患者在使用神经轴区域麻醉时所涉及风险的数据。制定指南以帮助医生将形成神经轴血肿的风险降至最低，监测患者是否出现此并发症，并在发生血肿时对患者进行最佳治疗。
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