我国外科非心血管手术抗血小板药应用指南的完善与纠错  

Improve and correct the Clinical Guide to Platelet Aggregation Inhibitors for no-cardiac surgery

作　　者：闫赋琴[1] 范贞 

机构地区：[1]武警总医院药剂科 [2]北京卫生法学会

出　　处：《中国临床药理学与治疗学》2014年第12期1352-1355,共4页Chinese Journal of Clinical Pharmacology and Therapeutics

基　　金：北京市社会科学基金(14ZHB010)

摘　　要：非心血管外科的手术前服用阿司匹林等抗血小板药物,《临床用药须知》、《中国国家处方集》（儿童版）都认为应当手术前5～7 d停阿司匹林,但5～7 d低于血小板在血液7～14 d的生存时间,围手术期易较大量出血.《临床用药须知》和《中国国家处方集》抗血小板药物阿司匹林、硫酸氯吡格雷注意事项建议修订为：为避免外科及口腔科择期手术中出血量增多,术前10～14 d应停用此药;若围手术期大出血,可输新鲜血小板以帮助止血.此外,抗血小板药噻氯匹定在《中国国家处方集》（儿童版）和《中国国家处方集》（2010年版）的注意事项择期手术前10～24 d应停用本品是书写错误,应修改为择期手术前10～14 d应停用本品.Platelet aggregation inhibitors therapy,such as aspirin or clopidegrel,should be stopped for 5-7 d before no-cardiac surgery in the Clinical Guide to the Chinese Pharmacopoeia 2010 and Chinese National Formulary for Children （CNFC）.Platelet regenerating time in blood,being 7-14 d,is longer than the time stopping therapy for 5-7 d.It would be blood preoperative for no-cardiac surgery because of lots of platelets without coagulation function existing in blood.The precaution of aspirin and clopidegrel in the Clinical Guide to the Chinese Pharmacopoeia 2010 and Chinese National Formulary（CNF） should be improved.To prevent bleeding in selective operations,no administration of aspirin and clopidegrel should be set at 10-14 days before the operation.If bleeding in or after the operation,fresh platelet should be transfused to stop the bleeding.The precaution of ticlopidine in the Chinese National Formulary 2010 and Chinese National Formulary for Children is not correct because no administrating ticlopidine 10-24 d before the operation should be corrected as 10-14 days before the operation.

关 键 词：阿司匹林 氯吡格雷 噻氯匹定 血小板 处方集 

分 类 号：R92[医药卫生—药学]