神经外科如何管理抗凝治疗？意大利神经外科学会（SINCH）的抗凝调查。
How do you manage ANTICOagulant therapy in neurosurgery? The ANTICO survey of the Italian Society of Neurosurgery (SINCH).
机构信息
Section of Neurosurgery, Department of Neuroscience (DINOGMI) IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
Università di Genova, Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze materno infantili (DINOGMI), IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 1016132, Genoa, Italy.
出版信息
BMC Neurol. 2021 Mar 3;21(1):98. doi: 10.1186/s12883-021-02126-7.
BACKGROUND
Anticoagulant assumption is a concern in neurosurgical patient that implies a delicate balance between the risk of thromboembolism versus the risk of peri- and postoperative hemorrhage.
METHODS
We performed a survey among 129 different neurosurgical departments in Italy to evaluate practice patterns regarding the management of neurosurgical patients taking anticoagulant drugs. Furthermore, we reviewed the available literature, with the aim of providing a comprehensive but practical summary of current recommendations.
RESULTS
Our survey revealed that there is a lack of knowledge, mostly regarding the indication and the strategies of anticoagulant reversal in neurosurgical clinical practice. This may be due a lack of national and international guidelines for the care of anticoagulated neurosurgical patients, along with the fact that coagulation and hemostasis are not simple topics for a neurosurgeon.
CONCLUSIONS
To overcome this issue, establishment of hospital-wide policy concerning management of anticoagulated patients and developed in an interdisciplinary manner are strongly recommended.
背景
抗凝假设是神经外科患者关注的一个问题，这涉及到血栓栓塞风险与围手术期出血风险之间的微妙平衡。
方法
我们对意大利的 129 个不同神经外科科室进行了一项调查，以评估管理正在服用抗凝药物的神经外科患者的实践模式。此外，我们还回顾了现有文献，旨在提供当前建议的全面但实用的总结。
结果
我们的调查显示，神经外科临床实践中在抗凝药物的适应证和逆转策略方面缺乏知识。这可能是由于缺乏针对抗凝神经外科患者护理的国家和国际指南，以及凝血和止血对于神经外科医生来说不是一个简单的话题。
结论
为了克服这个问题，强烈建议以跨学科的方式制定全院范围内的管理抗凝患者的政策。
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