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題名 | 手術期抗血小板劑過渡性治療--Case Report=A Case Report of Bridging Therapy with Antiplatelet Agents for Perioperative Management |
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作者 | 林俊杰; 陳鴻儀; Lin, Jiun-jie; Chen, Hung-yi; |
期刊 | 藥學雜誌 |
出版日期 | 20181200 |
卷期 | 34:4=137 2018.12[民107.12] |
頁次 | 頁102-107 |
分類號 | 418.23 |
語文 | chi |
關鍵詞 | 抗血小板製劑; 過渡性治療; 案例討論; |
中文摘要 | 在預防和治療心血管疾病發生,抗血小板製劑廣泛被運用,根據患者個人的栓塞 或出血的風險來使用此類的藥物。當病人需要進行開刀治療時,醫療團隊必須選擇適 當的抗血小板藥物。本案例替代藥物是 clexane 6000 IU/0.4 mL qd,後續觀察病人情 況良好。這幾個醫學會治療指引中,在手術期停用抗血小板藥物後的替代藥物可以用 heparin、LMWH 或 GP IIb/IIIa 抑制劑,但是在藥理上,heparin 對抗血小板的功能較 小,因此有學者不認為可以完全替代抗血小板藥物。短效型 GP IIb/IIIa 抑制劑可以考 慮使用於手術期間的過渡性治療,但是目前文獻上只有少數的研究,論及手術期間 GP IIb/IIIa 抑制劑的使用管理,故手術期間醫療團隊對中止或續用各類血小板藥物,仍需 進行徹底的風險效益評估。 |
英文摘要 | Antiplatelet agents are a typical therapy in preventing and treating cardiovascular events. Each patient has to be treated according to individual thrombotic and bleeding risk. When patients on antiplatelet agents present for surgery, the clinical team must chose optimal antiplatelet medications. In this case, clexane (6000 IU/0.4mL qd) was as a bridging agent. Patient had a good condition. There were guidelines that provided clinical advice for the use of a bridging agent, including unfractionated heparin, lowmolecular-weight heparin, or glycoprotein IIb/IIIa inhibitors during the perioperative period. Some experts demonstrated that heparin has relatively minor effects on platelets, and does not prevent a thrombotic event. Bridging therapy with short-acting GP IIb/IIIa inhibitors can be considered. However, there are few numbers of clinical trials in the literature on GP IIb/IIIa inhibitors for perioperative management. The perioperative team should perform in a risk–benefit analysis of stopping or continuing each of antiplatelet agent. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。