Douketis James D, Bakhsh Ebtisam
Department of Medicine, McMaster University and St. Joseph's Healthcare, Hamilton, ON, Canada.
Pol Arch Med Wewn. 2008 Apr;118(4):201-8.
The management of patients who require temporary interruption of warfarin therapy because of elective surgery or another invasive procedures is clinically important because of the increasing prevalence of patients who are receiving warfarin and the availability of low-molecular-weight heparins, which facilitate out-of-hospital perioperative anticoagulation. The two main issues that need to be considered in perioperative anticoagulant management is the patient's risk of a thromboembolic event when warfarin therapy is interrupted and the risk of bleeding that is associated with the surgery or procedure. An assessment of these factors will determine the optimal perioperative anticoagulant management approach. The overall objective of this review is to provide a practical approach relating to perioperative anticoagulation which can be used in everyday clinical practice.
由于接受华法林治疗的患者日益增多，且有低分子量肝素可供使用，这便于院外围手术期抗凝，因此，对于因择期手术或其他侵入性操作而需要暂时中断华法林治疗的患者进行管理具有重要的临床意义。围手术期抗凝管理需要考虑的两个主要问题是，中断华法林治疗时患者发生血栓栓塞事件的风险以及与手术或操作相关的出血风险。对这些因素进行评估将确定最佳的围手术期抗凝管理方法。本综述的总体目标是提供一种可用于日常临床实践的围手术期抗凝实用方法。
