摘要
神经外科急诊涉及颅内出血、颅脑创伤等,其致死率和致残率较高,并往往合并凝血功能障碍。一方面,颅脑损伤及颅内出血会继发凝血功能障碍;另一方面,由于抗凝、抗血小板药物在心脑血管病的治疗及预防应用中的逐年增加,使合并颅脑创伤或出血的患者死亡风险明显提高。神经外科急诊合并凝血功能障碍的患者在颅内压增高时需急诊手术干预,但凝血功能障碍又是手术的相对禁忌。本文综述了神经外科急诊合并凝血功能障碍的机制及治疗进展,分析此类患者的临床评估指标及变化规律,并总结了围术期进行相关紧急干预的措施和方法。
Neurosurgical emergencies including intracranial hemorrhage and head trauma have high mortality and morbidity rates and meanwhile are often accompanied with coagulation disorders. On one hand, co- agulation disorder follows traumatic brain injury; on the other hand, the increasing use of anticoagulant and anti- platelet treatment for cardiovascular diseases increases the risk of death among patients with brain trauma or bleeding. Once the intracranial pressure increases, such patients need emergency surgical intervention, but coag- ulation disorder is a relative contraindication. This article reviews the pathogenesis and treatment of coagulation disorders in patients with neurosurgical emergency. It also analyzes clinical monitoring indices for such patients and their variations and summarizes the strategies and measures of perioperative management.
出处
《中国医学科学院学报》
CAS
CSCD
北大核心
2013年第5期576-580,共5页
Acta Academiae Medicinae Sinicae
关键词
神经外科
急诊
凝血功能障碍
机制
治疗
neurosurgery
emergency
coagulation disorder
pathogenesis
treatment
