·综述·冠心病患者行非心脏手术围术期抗血小板治疗管理策略白瑾,张永珍∗(北京大学第三医院心血管内科,北京100191)【摘要】抗血小板治疗是冠心病二级预防的基石,但有增加出血的潜在风险,围术期抗血小板治疗决策务必要权衡个体血栓与出血风险和推迟非心脏手术潜在后果之间的平衡。围术期抗血小板治疗的管理应个体化,由多学科小组和患者共同决策,将血栓风险和出血风险降至最低。目前指南提供的建议并不一致,优化管理策略仍未确定。【关键词】冠心病;非心脏手术;抗血小板治疗;出血;主要不良心血管事件【中图分类号】R541【文献标志码】A【DOI】10.11915/j.issn.1671-5403.2023.10.168收稿日期:2023-01-03;接受日期:2023-01-29基金项目:北京慢性病防治与健康教育研究会科研项目(BJMB0012022028003)通信作者:张永珍,E-mail:zhangy_zhen@163.comPerioperativemanagementofantiplatelettherapyinpatientswithcoronaryarterydiseaseundergoingnon-cardiacsurgeryBaiJin,ZhangYongzhen∗(DepartmentofCardiology,ThirdHospitalofPekingUniversity,Beijing100191,China)【Abstract】Antiplatelettherapyisthecornerstoneofsecondarypreventionofcoronaryarterydiseasebutpotentiallyincreasestheriskofbleeding.Aprocessofshareddecision-makingforperioperativeantiplatelettherapymustbalanceanindividual′sthromboticandbleedingrisk,andthepotentialunintendedconsequencesofdelayingnon-cardiacsurgery.Perioperativemanagementofantiplatelettherapyshouldbeindividuallytailoredbasedonconsensusfrommultidisciplinaryteamandpatienttominimizeboththromboticandbleedingrisks.Currentguidelinesdonotprovideconsistentrecommendationsonthistopic,andtheoptimalapproachinthesepatientsisyettobedetermined.【Keywords】coronaryarterydisease;non-cardiacsurgery;antiplatelettherapy;bleeding;majoradversecardiovasculareventsThisworkwassupportedbytheScientificResearchProjectofBeijingInstituteofChronicDiseasePreventionandHealthEducation(BJMB0012022028003).Correspondingauthor:ZhangYongzhen,E-mail:zhangy_zhen@163.com抗血小板治疗(antiplatelettherapy,APT)是冠心病指南导向药物治疗的基石,研究显示,经皮冠状动脉介入(percutaneouscoronaryintervention,PCI)治疗后2年内需要行非心脏手术(non-cardiacsurgery,NCS)的发生率高达25%...
