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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >Safety of Early Pharmacological Thromboprophylaxis after Subarachnoid Hemorrhage
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Safety of Early Pharmacological Thromboprophylaxis after Subarachnoid Hemorrhage

机译：蛛网膜下腔出血后早期药理性血栓预防的安全性

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Objective: The recent guidelines on management of aneurysmal subarachnoid hemorrhage (aSAH) advise pharmacological thromboprophylaxis (PTP) after aneurysm obliteration. However, no study has addressed the safety of PTP in the aSAH population. Therefore, the aim of this study was to assess the safety of early PTP after aSAH. Methods: Retrospective cohort of aSAH patients admitted between January 2012 and June 2013 in a single high-volume aSAH center. Traumatic SAH and perimesencephalic hemorrhage patients were excluded. Patients were grouped according to PTP timing: early PTP group (PTP within 24 hours of aneurysm treatment), and delayed PTP group (PTP started > 24 hours). Results: A total of 174 SAH patients (mean age 56.3 +/- 12.5 years) were admitted during the study period. Thirty-nine patients (22%) did not receive PTP, whereas 135 patients (78%) received PTP after aneurysm treatment or negative angiography. Among the patients who received PTP, 65 (48%) had an external ventricular drain. Twenty-eight patients (21%) received early PTP, and 107 (79%) received delayed PTP. No patient in the early treatment group and three patients in the delayed PTP group developed an intracerebral hemorrhagic complication. Two required neurosurgical intervention and one died. These three patients were on concomitant PTP and dual antiplatelet therapy. Conclusions: The initiation of PTP within 24 hours may be safe after the treatment of a ruptured aneurysm or in angiogram-negative SAH patients with diffuse aneurysmal hemorrhage pattern. We suggest caution with concomitant use of PTP and dual antiplatelet agents, because it possibly increases the risk for intracerebral hemorrhage.
机译：目的：最新的动脉瘤蛛网膜下腔出血（aSAH）处理指南建议在动脉瘤闭塞后进行药理性血栓预防（PTP）。但是，尚无研究针对aSAH人群中PTP的安全性。因此，本研究的目的是评估aSAH后早期PTP的安全性。方法：回顾性队列研究于2012年1月至2013年6月期间在单个高容量aSAH中心收治的aSAH患者。外伤性SAH和中脑周围出血患者除外。根据PTP时机对患者进行分组：早期PTP组（动脉瘤治疗后24小时内PTP）和延迟PTP组（PTP开始> 24小时）。结果：在研究期间共收治174名SAH患者（平均年龄56.3 +/- 12.5岁）。三十九名患者（22％）未接受PTP，而135名患者（78％）在动脉瘤治疗或血管造影阴性后接受了PTP。在接受PTP的患者中，有65名（48％）患有外部心室引流。 28位患者（21％）接受了早期PTP，107位患者（79％）获得了延迟PTP。早期治疗组中无患者，延迟PTP组中有3例发生脑出血并发症。两名需要神经外科手术干预，一名死亡。这三例患者同时接受PTP和双重抗血小板治疗。结论：在动脉瘤破裂后或血管造影阴性的SAH弥漫性动脉瘤出血型患者中，PTP治疗24小时之内可能是安全的。我们建议同时使用PTP和双重抗血小板药时要小心，因为它可能会增加脑出血的风险。

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