Feltgen N, Hoerauf H, Noske W, Hager A, Koscielny J
Universitäts-Augenklinik, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland.
Augenklinik, Städtisches Klinikum Brandenburg, Hochschulklinikum der Medizinischen Hochschule Brandenburg, Brandenburg, Deutschland.
Ophthalmologe. 2016 Dec;113(12):1010-1022. doi: 10.1007/s00347-016-0368-8.
In ophthalmology many patients undergo surgical treatment who need to take anticoagulant medication due to cardiovascular diseases. The proper handling of these drugs requires both correct assessment of the risk of thromboembolism as well as the rating of the risk of surgery-related hemorrhages. While there are established recommendations for estimation of the risk of thromboembolism based on a large body of prospective randomized trials, data regarding the evaluation of the related complications secondary to ophthalmic surgery are limited. In comparison to other surgical procedures, most interventions in ophthalmic surgery tend to have a relatively low risk of bleeding; therefore, in general there is no need to convert or discontinue anticoagulant drugs in patients undergoing opthalmic surgery. The sparse data available justifying the abrupt termination of anticoagulation are contrary to the approach currently widely distributed in clinical practice. This overview covers the relevant knowledge of the perioperative use of anticoagulant drugs. In addition, the data on the risk of hemorrhage in ophthalmological procedures are presented and discussed.
在眼科领域，许多因心血管疾病而需要服用抗凝药物的患者会接受手术治疗。正确使用这些药物既需要准确评估血栓栓塞风险，也需要评估与手术相关的出血风险。虽然基于大量前瞻性随机试验已确立了评估血栓栓塞风险的建议，但有关眼科手术继发相关并发症评估的数据有限。与其他外科手术相比，大多数眼科手术干预的出血风险相对较低；因此，一般而言，接受眼科手术的患者无需停用或更换抗凝药物。现有支持突然停用抗凝治疗的稀疏数据与目前临床实践中广泛采用的方法相悖。本综述涵盖了抗凝药物围手术期使用的相关知识。此外，还介绍并讨论了眼科手术中出血风险的数据。
