脑出血后重启抗凝治疗的研究进展

抗凝治疗已广泛用于心房颤动和（或）机械性心脏瓣膜患者以预防血栓栓塞事件，尤其是 预防缺血性卒中的发生。然而，脑出血后是否应继续抗凝治疗及何时重启抗凝治疗仍是临床未解的 难题。虽然目前已有数项大样本观察性研究和Meta分析提示脑出血后重启抗凝治疗可降低血栓栓塞 并发症且没有明显增加出血并发症，但是尚缺乏随机对照试验进一步证实。因此，目前在缺乏指导 临床决策的高质量临床研究证据的情况下，临床实践中应权衡患者血栓栓塞事件风险和脑出血复发 风险进行个体化处理。

Advances in Anticoagulant Resumption after Intracerebral Hemorrhage

Anticoagulation is currently recommended and commonly used in patients with atrial
fibrillation and/or mechanical prosthetic heart valves to prevent thromboembolism events, especially
stroke. However, the decision-making about whether and when to resume anticoagulant after
intracerebral hemorrhage (ICH) is still an unsolved problem due to lacking randomized controlled
trials. Several large-scale observational studies and meta analysis showed that anticoagulant
resumption after ICH decreased thromboembolic complications without increasing hemorrhagic
complications. Given the lack of high-quality evidence, clinicians should carefully balance the risk
of thromboembolism and recurrent ICH in individual patients.