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首页> 外文期刊>American journal of rhinology >Endoscopic sinus surgery in patients receiving anticoagulant or antiplatelet therapy.
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Endoscopic sinus surgery in patients receiving anticoagulant or antiplatelet therapy.

机译：接受抗凝或抗血小板治疗的患者的内窥镜鼻窦手术。

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BACKGROUND: Endoscopic Sinus Surgery (ESS) has not been studied in patients receiving anticoagulant or antiplatelet therapy. Classifing this procedure into a bleeding risk category needs to be done to safely manage these therapies perioperatively. METHODS: Design: Retrospective case control study of prospectively collected data. Setting: Academic tertiary referral center. Patients: 42 patients receiving anticoagulant therapy who underwent an endoscopic sinus surgery between October 1997 and December 2005, compared to a control group of 42 patients matched for age and gender. RESULTS: The mean estimated blood loss (EBL) during surgery was slightly higher for the control group without reaching a statistically significant difference (p = 0.14). EBL was significantly higher when more sinuses were opened during surgery (p = 0.001). There was no reported major postoperative bleeding related to anticoagulation. All patients were able to resume their anticoagulation or antiplatelet therapy after the surgery. CONCLUSION: ESS is a safe procedure when performed in patients receiving anticoagulation or antiplatet therapy, and could be classified as a moderate bleeding risk surgery. Stopping the medication prior to the surgery is mandatory. However, anticoagulation could be resumed early postoperatively because it does not seen to increase the risk for bleeding. Perioperative bridging with heparin should only be dictated by the patient's condition, not by the procedure itself.
机译：背景：内镜鼻窦手术（ESS）尚未在接受抗凝或抗血小板治疗的患者中进行研究。需要将该程序分类为出血风险类别，以在围手术期安全地管理这些疗法。方法：设计：回顾性病例对照研究的前瞻性收集的数据。地点：大学高等教育转诊中心。患者：42例接受抗凝治疗的患者在1997年10月至2005年12月间接受了内窥镜鼻窦手术，而对照组为42例年龄和性别相匹配的患者。结果：对照组的术中平均估计失血量（EBL）略高，但无统计学差异（p = 0.14）。手术期间打开更多鼻窦时，EBL显着升高（p = 0.001）。尚无术后抗凝相关大出血的报道。手术后所有患者均可恢复抗凝或抗血小板治疗。结论：在接受抗凝或抗血小板治疗的患者中进行ESS是一种安全的方法，可以归类为中度出血风险手术。手术前必须停药。但是，抗凝剂可以在术后早期恢复，因为它并未增加出血的风险。围手术期使用肝素的桥接仅应由患者的状况决定，而不应由手术本身决定。

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