在一名近期接受冠状动脉支架置入术并接受氯吡格雷和阿司匹林治疗的患者中，在阻抗凝集测定法引导下顺利拔除硬膜外导管。
Uneventful removal of an epidural catheter guided by impedance aggregometry in a patient with recent coronary stenting and treated with clopidogrel and acetylsalicylic acid.
作者信息
Bergmann Lars, Kienbaum Peter, Görlinger Klaus, Peters Jürgen
机构信息
Klinik für Anästhesiologie und Intensivmedizin, Universität Duisburg-Essen, Universitätsklinikum Essen, Essen, Germany.
出版信息
Reg Anesth Pain Med. 2007 Jul-Aug;32(4):354-7. doi: 10.1016/j.rapm.2007.06.007.
OBJECTIVE
This report suggests that impedance aggregometry can be helpful to assess optimum time for and minimize the risk of catheter removal during double antiplatelet therapy.
CASE REPORT
A 52-year-old patient undergoing cystectomy during combined general and epidural anesthesia suffered an acute myocardial infarction, and required coronary artery stenting and dual antiplatelet function therapy.
CONCLUSIONS
Balancing the risks of stent occlusion and epidural bleeding, bedside impedance aggregometry helped to identify the optimum time window for epidural catheter removal with the lowest bleeding risk in this patient.
目的
本报告表明，阻抗聚集测定法有助于评估双重抗血小板治疗期间拔除导管的最佳时间并将风险降至最低。
病例报告
一名52岁患者在全身麻醉联合硬膜外麻醉下行膀胱切除术时发生急性心肌梗死，需要进行冠状动脉支架置入和双重抗血小板功能治疗。
结论
权衡支架闭塞和硬膜外出血的风险，床边阻抗聚集测定法有助于确定该患者拔除硬膜外导管的最佳时间窗，使其出血风险最低。
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