乳腺癌合并风湿性心脏病患者围手术期的治疗  

Treatment of breast cancer patients coincided with rheumatic heart disease during perioperative period

作　　者：邢雷[1] 刘洪[1] 

机构地区：[1]重庆医科大学附属第一医院,重庆400000

出　　处：《临床医药文献电子杂志》2016年第58期11473-11475,共3页Electronic Journal of Clinical Medical Literature

摘　　要：目的探讨乳腺癌合并风湿性心脏病患者围手术期的治疗。方法选取我院2007年1月~2011年8月收治的乳腺癌合并风湿性心脏病的患者2400例,回顾性分析其围手术期治疗情况。结果 2400例收治的乳腺癌患者中有合并风湿性心脏病2例,年龄分别为71岁和55岁。其中合并房颤1例,二尖瓣金属瓣膜置换术后1例,均行华法林抗凝治疗。两例患者于术前5天停用华法林,同时予以低分子肝素或磺达肝癸钠抗凝治疗,术中仔细止血,术后视情况予以开始抗凝治疗。患者术后24 h内均出现切口区域瘀斑血肿,予以调整抗凝药物,加强引流及止血等措施后好转。结论乳腺癌患者合并风心病患者因基础疾病较特殊,其围手术期治疗也较复杂,过分抗凝或止血药物治疗均会导致不良反应。围手术期应注意监测和调整患者INR值,术中需仔细止血,尽量结扎止血,减少电凝,术后密切观察患者伤口局部情况,加强引流,必要时加用止血药,多可获得较好的疗效。Objective To study treatment of breast cancer patients coincided with rheumatic heart disease during perioperative period.Methods Retrospectively analyze the data of the breast cancer patients coincided with rheumatic heart disease in almost 2400 patients with breast cancer, from January,2007 to August,2011. Results Almost 2400 breast cancer patients were admitted since January,2007 to August,2011,and rheumatic heart disease was found in 2 patients at age of 71 and 55 respectively.Both of them were under anticoagulant therapy by using warfarin.Of these two patients,one Coincided with fibrillation atrial and another after mitral valve replacement. Warfarin is stopped 5 days and heparin or arixtra was used before the surgery and restarted in 5 days and more than a month respectively after the surgery.Conclusions The treatment of breast cancer patients coincided with rheumatic heart disease during perioperative period is complicated.In order to get a good therapeutic effect,we should pay attention to the INR and the wound.

关 键 词：乳腺癌 风湿性心脏病 围手术期 治疗 

分 类 号：R541.2[医药卫生—心血管疾病]