长期接受抗凝抗聚药物治疗病人并发脑出血的治疗分析

目的 探讨长期接受抗凝抗聚药物治疗病人发生脑出血的治疗方法及疗效。方法 回顾性分析2014年8月至2018年8月收治的33例长期接受抗凝抗聚药物治疗的脑出血的临床资料。保守治疗10例，急诊开颅血肿清除+去骨瓣减压术7例，钻孔引流术16例。结果 术后死亡1例（3%）。32例平均随访6个月，依据日常生活能力量表:Ⅰ级2例，Ⅱ级11例，Ⅲ级12例，Ⅳ级5例，Ⅴ级2例。结论 对长期接受抗凝抗聚药物治疗的脑出血，应密切监测凝血功能及相关指标参数，根据病人的具体情况选择针对性的治疗措施。

Treatment of long-term anticoagulation and antiaggregation-related cerebral hemorrhage: single center experience in 33 cases

Objective To summarize the clinical experience in treating the cerebral hemorrhage in patients who received long-term anticoagulation and antiaggregation therapy (LTAAT). Methods The clinical data of 33 consecutive patients with cerebral hemorrhage receiving LTAAT, who were treated in Department of Neurosurgery of General Hospital of Central Theater from August, 2014 to August, 2018, were analyzed retrospectively. Of these 33 patients, 10 were conservatively treated, 7 by removal of intracranial hematomas and skull bone flaps and 16 by skull drilling and drainage of intracranial hematomas. Results Of these 33 patients, 1 (3.0%) died, 2 (6.1%) belonged in the activities of daily living grade I, 11 (33.3%) in grade Ⅱ, 12 (36.4%) in grade Ⅲ, 5 (15.2%) in grade Ⅳ, and 2 (6.1%) in grade V. Conclusions The coagulation function and related indicators and parameters should be closely monitored in the patients with cerebral hemorrhage who have received LTAAT, and the methods directing against their specific conditions should are selected.