Rupprecht Hans-Jürgen, Blank Ralf, Konradi Dorothee, Andreas Klaus, Auerbach Holger
Medizinische Klinik, Klinikum Rüsselsheim, Rüsselsheim.
Herz. 2008 Jun;33(4):254-9. doi: 10.1007/s00059-008-3137-x.
The platelet function inhibitors (PFI) acetylsalicylic acid (ASA) and clopidogrel are widely used in a broad spectrum of atherothrombotic diseases, either as mono- or dual antiplatelet therapy. Platelet function is inhibited for the whole lifespan of platelets (10 days). In case of surgical procedures the bleeding risk under continued antiplatelet therapy has to be balanced against the risk of ischemic complications due to withdrawal of antiplatelet therapy. Especially after stent implantation, the high risk and unfavorable prognosis of stent thrombosis have to be considered. Whereas surgical procedures with a low bleeding risk may be performed with continued antiplatelet therapy, there is a need for partial or total discontinuation of antiplatelet therapy in surgical procedures with higher bleeding risks.
血小板功能抑制剂(PFI)阿司匹林(ASA)和氯吡格雷广泛用于多种动脉粥样硬化血栓形成疾病,可作为单药抗血小板治疗或双联抗血小板治疗。血小板功能在血小板的整个生命周期(10天)内受到抑制。在进行外科手术时,持续抗血小板治疗下的出血风险必须与因停用抗血小板治疗而导致的缺血性并发症风险相权衡。特别是在支架植入后,必须考虑支架血栓形成的高风险和不良预后。对于出血风险较低的外科手术,可在持续抗血小板治疗的情况下进行,而对于出血风险较高的外科手术,则需要部分或完全停用抗血小板治疗。