抗凝病人硬膜外麻醉——三年临床病例分析  

Epidural anesthesia for patients receiving anticoagulation treatment——clinical analysis for three years＇ cases

作　　者：韩志国[1] 赵建英[1] 李宝珠[1] 闫妮[1] 安刚[1] 

机构地区：[1]大连医科大学附属第一医院麻醉科,116011

出　　处：《国际麻醉学与复苏杂志》2007年第3期197-199,共3页International Journal of Anesthesiology and Resuscitation

摘　　要：目的评价抗凝病人硬膜外麻醉的安全性。方法回顾分析本院2003-2006年107例关节置换或血管成形手术病例。关节置换病人术前12 h应用低分子肝素抗凝,血管成形病人在术中应用肝素抗凝。总共50例病人接受硬膜外麻醉,20例病人接受全麻联合硬膜外麻醉,29例病人接受全麻。结果所有病人均没有发生与硬膜外血肿有关的并发症。发生其它并发症的有10例,其中2例（3．45％）发生在硬膜外组,5例（25％）发生在全麻联合硬膜外组,3例（10．34％）发生在全麻组。结论硬膜外麻醉不是抗凝病人的绝对禁忌。掌握好硬膜外穿刺置管的时机,可以避免发生硬膜外血肿的风险。硬膜外麻醉在多方面优于全麻。Objective To appraise the safety of epidural block for patients receiving anticoagulation treatment. Methods One hundred and seven patients undergoing joint replacement or vascular reconstruction from 2003 to 2006 were analyzed retrospectively. Patients undergoing joint replacement were anticoagulated with low molecular weight heparin （LMWH） 12 h before surgery, and those undergoing vascular reconstruction were anticoagulated with heparin during operation. Patients received continuous epidural block （50 cases）, combination of epidural block and general anesthesia （20 cases） or single general anesthesia （29 cases）. Results No untoward neurological events associated to epidural hematoma occurred. Some other complications occurred in 10 patients including 2 cases with epidural block, 5 cases receiving combination anesthesia and 3 cases with single general anesthesia. Conclusion Epidural block is not interdictory for patients receiving anticoagulation treatment. Continuous epidural block offers some advantages over general anesthesia.

关 键 词：硬膜外麻醉 抗凝 

分 类 号：R614[医药卫生—麻醉学]