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首页> 外文期刊>Journal of Clinical Medicine >Management of Bleeding Events Associated with Antiplatelet Therapy: Evidence, Uncertainties and Pitfalls
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Management of Bleeding Events Associated with Antiplatelet Therapy: Evidence, Uncertainties and Pitfalls

机译：与抗血小板治疗相关的出血事件：证据，不确定性和陷阱

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摘要

Bleeding complications are common in patients treated with antiplatelet agents (APA), but their management relies on poor evidence. Therefore, practical guidelines and guidance documents are mainly based on expert opinion. The French Working Group on Perioperative Haemostasis provided proposals in 2018 to enhance clinical decisions regarding the management of APA-treated patients with a bleeding event. In light of these proposals, this review discusses the evidence and uncertainties of the management of patients with a bleeding event while on antiplatelet therapy. Platelet transfusion is the main option as an attempt to neutralise the effect of APA on primary haemostasis. Nevertheless, efficacy of platelet transfusion to mitigate clinical consequences of bleeding in patients treated with APA depends on the type of antiplatelet therapy, the time from the last intake, the mechanism (spontaneous versus traumatic) and site of bleeding and the criteria of efficacy (in vitro, in vivo). Specific antidotes for APA neutralisation are needed, especially for ticagrelor, but are not available yet. Despite the amount of information that platelet function tests are expected to give, little data support the clinical benefit of using such tests for the management of bleeding events in patients treated or potentially treated with APA.
机译：在用抗血小板药物（APA）治疗的患者中，出血并发症是常见的，但其管理依赖于差的证据。因此，实用的指导方针和指导文件主要基于专家意见。 Feroperative Hoemostasis的法国工作组提供了2018年的建议，以提高有关APA治疗患者的临床决策，具有出血事件。鉴于这些提案，本综述讨论了在抗血小板治疗的同时患有出血事件的患者管理的证据和不确定性。血小板输注是主要选择，以试图中和APA对原发性血症的影响。尽管如此，血小板输注减轻了APA治疗的患者出血的临床后果的疗效取决于抗血小板治疗的类型，从最后一次摄入量，机制（自发与创伤）和出血部位以及疗效标准（体外体外）。需要对APA中和的特异性解毒剂，特别是对于TicagreloR，但尚未使用。尽管预期血小板函数测试的信息量，但很少的数据支持使用此类试验的临床益处，用于管理治疗或潜在治疗APA的患者的出血事件。

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