长期接受抗凝抗聚药物治疗病人并发脑出血的治疗分析  

Treatment of long-term anticoagulation and antiaggregation-related cerebral hemorrhage: single center experience in 33 cases

作　　者：刘彬彬 卢玉昭 岳建人 曹成龙[2] 马盼 徐国政 宋健 LIU Bin-bin;LU Yu-zhao;YUE Jian-ren;CAO Cheng-long;MA Pan;XU Guo-zheng;SONG jian(Medical School,Wuhan University of Sciences and Technology,Wuhan 430070,China;Graduate School,Nanfang Medical University,Guangzhou 510515,China;Department of Neurosurgery,General Hospital,Central Theater,PLA,Wuhan 430070,China)

机构地区：[1]武汉科技大学医学院,武汉430065 [2]南方医科大学研究生院,广州510515 [3]中国人民解放军中部战区总医院神经外科,武汉430070

出　　处：《中国临床神经外科杂志》2019年第7期416-418,共3页Chinese Journal of Clinical Neurosurgery

基　　金：国家自然科学基金(81571049;81400865)

摘　　要：目的探讨长期接受抗凝抗聚药物治疗病人发生脑出血的治疗方法及疗效。方法回顾性分析2014年8月至2018年8月收治的33例长期接受抗凝抗聚药物治疗的脑出血的临床资料。保守治疗10例,急诊开颅血肿清除+去骨瓣减压术7例,钻孔引流术16例。结果术后死亡1例(3%)。32例平均随访6个月,依据日常生活能力量表:Ⅰ级2例,Ⅱ级11例,Ⅲ级12例,Ⅳ级5例,Ⅴ级2例。结论对长期接受抗凝抗聚药物治疗的脑出血,应密切监测凝血功能及相关指标参数,根据病人的具体情况选择针对性的治疗措施。Objective To summarize the clinical experience in treating the cerebral hemorrhage in patients who received longterm anticoagulation and antiaggregation therapy (LTAAT). Methods The clinical data of 33 consecutive patients with cerebral hemorrhage receiving LTAAT, who were treated in Department of Neurosurgery of General Hospital of Central Theater from August, 2014 to August, 2018, were analyzed retrospectively. Of these 33 patients, 10 were conservatively treated, 7 by removal of intracranial hematomas and skull bone flaps and 16 by skull drilling and drainage of intracranial hematomas. Results Of these 33 patients, 1 (3.0%) died, 2 (6.1%) belonged in the activities of daily living grade I, 11 (33.3%) in grade Ⅱ, 12 (36.4%) in grade Ⅲ, 5 (15.2%) in grade Ⅳ, and 2 (6.1%) in grade V. Conclusions The coagulation function and related indicators and parameters should be closely monitored in the patients with cerebral hemorrhage who have received LTAAT, and the methods directing against their specific conditions should are selected.

关 键 词：脑出血 凝血功能 抗凝药物 抗聚药物 治疗 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R651.12[医药卫生—临床医学]