原发性和转移性脑肿瘤患者抗凝治疗相关问题探讨

原发性和转移性脑肿瘤患者发生静脉血栓栓塞症和颅内出血的风险均会增加,因此,必须对这类患者抗凝治疗的潜在益处与颅内出血风险加以权衡。本文探讨了原发性和转移性脑肿瘤患者颅内出血的风险以及抗凝治疗的现有证据和近期研究。对于大多数原发性和转移性脑肿瘤患者,使用低分子肝素及新型口服抗凝药谨慎抗凝治疗不会进一步增加颅内出血的风险,应结合患者的具体情况选择合适的抗凝治疗方案,同时还需关注药物相互作用对出血风险的影响。

Discussion on the Anticoagulant Therapy for Patients with Primary and Metastatic Brain Tumors

The risk of both venous thromboembolism and intracranial hemorrhage is increased in patients with primary and metastatic brain tumors.Therefore,the potential benefits of anticoagulant therapy for such patients must be weighed against the risk of intracranial hemorrhage.We discussed the risk of intracranial hemorrhage in patients with primary and metastatic brain tumors,as well as the existing evidence and recent research of anticoagulant therapy.For most of the primary and metastatic brain tumors,anticoagulation with low molecular weight heparin and novel oral anticoagulants carefully will not further increase the risk of intracranial hemorrhage.Appropriate anticoagulant therapy should be selected according to the specific situation of patients.Meanwhile,it is also necessary to pay attention to the influence of drug interaction on the risk of bleeding.