2021 年第 5 期 第 16 卷

经皮冠状动脉介入后行外科手术桥接抗血小板药物治疗的研究进展

Research progress on surgical bridging of antiplatelet drug therapy after percutaneous coronary intervention

作者：柳弘历于洋

英文作者：Liu Hongli Yu Yang

单位：首都医科大学附属北京安贞医院心外二科100029

英文单位：The Second Department of Cardiac Surgery Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：冠状动脉血栓；抗血小板；围术期；桥接治疗

英文关键词：Coronarythrombus;Antiplatelet;Perioperativepriod;Bridgingtherapy

• 摘要：

• 在心脏支架置入术后6个月内由于外科手术中断口服双联抗血小板治疗的患者有发生血栓事件的风险。考虑到术中止血与术后引流问题，临床实践中医师对停药与桥接的治疗决策有较大差异，此外，对于气管插管的患者，口服给药途径的抗血小板药物应用受限。该类患者中断抗血小板药物后，无保护的暴露时间越长，发生血栓事件的概率越高。静脉途径抗血小板药物半衰期短，是理想的桥接药物。本文就该类患者抗血小板药物治疗的应用总结阐述。

• The discontinuation of dual antiplatelet therapy results in the risk of thrombotic events in patients undergoing surgical operation within 6 months after coronary stent implantation. Considering the surgical hemostasis and postoperative drainage, doctors have quite different antiplatelet therapy decisions on stopping and bridging in clinical practice. In addition, in patients with endotracheal intubation, the use of oral antiplatelet is limited. After discontinuation of antiplatelet drugs in these patients, the longer the unprotected exposure time, the higher probability of thrombosis events will be. Intravenous antiplatelet drugs are ideal bridging drugs because of the short half-life. This article summarizes the application of antiplatelet drug therapy in such patients.