特殊情况的抗栓治疗台州资料讲解.ppt

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1、特殊情况的抗栓治疗台州缺血性脑卒中出血转化的抗栓治疗2010中国卒中急性期指南缺血性脑卒中出血转化的抗栓治疗3.对于出血性脑梗死患者，根据患者的临床情况（无症状和出血量少）及抗凝适应症时，可以考虑继续抗凝。ClassIIb;LevelofEvidenceCGuidelinesforthePreventionofStrokeinPatientsWithStrokeandTransientIschemicStroke.publishedonlineMay1,2014特殊情况的抗栓治疗缺血性脑卒中脑出血转化颅内出血房颤合并冠心病围手术期管理缺血性脑血管疾病患者抗栓治疗脑出血后重新开始抗栓治疗的

2、决策制定，依赖于随后的动脉或静脉血栓栓塞的风险大小、脑出血再发的风险、病人的全身情况，所以对每个病人必须制定个体化的方案。*脑梗死风险相对较低病人（如房颤但没有缺血性脑卒中史）和脑出血再发风险较高（如高龄的脑叶出血或可疑淀粉样脑血管病患者）或者整个神经系统功能很差，可以考虑应用抗血小板药物来预防缺血性脑卒中。颅内出血后的抗凝治疗ClassIIb;LevelofEvidenceBGuidelinesforthePreventionofStrokeinPatientsWithStrokeandTransientIschemicStroke.publishedonlineMay1,20142.

3、对于急性脑出血、蛛网膜下腔出血或硬脑膜下出血后，何时恢复或开始抗凝治疗，最佳时机尚无定论。大多数病人来说，发病至少1周以上较为合理颅内出血后的抗凝治疗:ClassIIb;LevelofEvidenceBGuidelinesforthePreventionofStrokeinPatientsWithStrokeandTransientIschemicStroke.publishedonlineMay1,2014特殊情况的抗栓治疗缺血性脑卒中脑出血转化颅内出血房颤合并冠心病围手术期管理缺血性脑血管疾病患者抗栓治疗ForpatientswithAFandstablecoronaryartery

4、disease(eg,noacutecoronarysyndromewithinthepreviousyear)whochooseoralanticoagulationsuggestadjusted-doseVKAtherapyalone(targetINRrange,2.0-3.0)ratherthanthecombinationofadjusted-doseVKAtherapyandaspirin(Grade2C)AntithromboticTherapyforAtrialFibrillationAntithromboticTherapyandPreventionofThrombos

5、is,9thed：AmericanCollegeofChestPhysiciansEvidence-BasedClinicalPracticeGuidelinesForpatientswithAFatintermediatetohighriskofstroke(eg,CHADS2score≥1)whoexperienceanacutecoronarysyndromeanddonotundergointracoronarystentplacementsuggestforthefirst12monthsadjusted-doseVKAtherapy(INR2.0-3.0)plussingle

6、antiplatelettherapyratherthandualantiplatelettherapy(eg,aspirinandclopidogrel)ortripletherapy(eg,warfarin,aspirin,andclopidogrel)(Grade2C).AntithromboticTherapyforAtrialFibrillationAntithromboticTherapyandPreventionofThrombosis,9thed：AmericanCollegeofChestPhysiciansEvidence-BasedClinicalPracticeG

7、uidelinesForpatientswithAFatintermediatetohighriskofstrokeAfterthefirst12monthsantithrombotictherapyissuggestedasforpatientswithAFandstablecoronaryarterydiseaseAntithromboticTherapyforAtrialFibrillationAntithromboticTh