Montefiore Medical Center, Department of Anesthesiology, Bronx, NY, USA.
Br J Anaesth. 2009 Dec;103 Suppl 1:i14-22. doi: 10.1093/bja/aep318.
Patients with cardiovascular disease have an array of haemostasis disorders that predispose to the development of thrombotic and embolic disease states. These patients are often maintained on anti-thrombotic medication to prevent adverse cardiovascular events. Patients undergoing cardiac surgery also have haemostatic disorders that include their intrinsic disease state, adjunctive medication, and the coagulation disturbances induced by cardiopulmonary bypass. The following review introduces the monitors that are available for monitoring perioperative coagulation, with an emphasis on cardiovascular surgery. Heparin monitors, platelet function monitors for use in transfusion algorithms, and monitoring anti-platelet drugs will be discussed.
心血管疾病患者存在一系列止血功能紊乱,这些紊乱易导致血栓栓塞性疾病状态的发生。这些患者通常需要接受抗血栓药物治疗,以预防不良心血管事件。接受心脏手术的患者也存在止血功能紊乱,包括其固有疾病状态、辅助药物以及心肺转流引起的凝血功能障碍。本综述介绍了可用于监测围手术期凝血功能的监测仪,重点介绍了心血管手术。本文将讨论肝素监测仪、用于输血算法的血小板功能监测仪以及抗血小板药物的监测。