Perez Augustus J, Grant Gerald A
Pediatric Neurosurgery, Department of Neurosurgery, Stanford University Medical Center, 300 Pasteur Drive Room R211, MC 5325, Stanford, CA 94305, USA.
Department of Neurosurgery, Stanford University Medical Center, 300 Pasteur Drive Room R211, MC 5327, Stanford, CA 94305, USA.
Neurosurg Clin N Am. 2018 Oct;29(4):529-535. doi: 10.1016/j.nec.2018.06.009.
Long-term anticoagulant therapy prevents thrombosis. Management of neurosurgical patients with conditions such as atrial fibrillation, mechanical heart valves, and other prothrombotic states necessitates application of a strategy to mitigate hemorrhagic complications of anticoagulation. Development of direct oral anticoagulants, which include the direct thrombin and factor X inhibitors, yields new considerations to be had, in particular, the introduction of reversal agents. This article reviews the more common chronic clinical entities that require the use of prolonged anticoagulant therapy with special consideration for neurosurgical patients. It also includes a discussion of established treatment strategies across available treatment options.
长期抗凝治疗可预防血栓形成。对于患有心房颤动、机械心脏瓣膜及其他血栓前状态等疾病的神经外科患者，管理时需要采用一种策略来减轻抗凝治疗的出血并发症。直接口服抗凝剂的发展，包括直接凝血酶抑制剂和X因子抑制剂，带来了新的考虑因素，尤其是逆转剂的引入。本文回顾了更常见的需要长期抗凝治疗的慢性临床病症，并特别考虑了神经外科患者。还讨论了现有治疗选择中的既定治疗策略。
