手術前後Warfarin治療策略探討

Strategies of Perioperative Warfarin Management

Warfarin 被廣泛使用於預防及治療各種血栓栓塞疾患，每年約有10%接受抗血栓治療的病人接受手術或侵入性治療，此時需審慎評估停用warfarin 而發生栓塞或續用導致出血之危險性。藉報告一案例疑似因停用抗凝血劑天數較長，發生嚴重次發性腦部栓塞，以探討手術前後該如何及時匯總患者病情變化，評估抗凝血劑的使用策略。更期望在就醫如此便利的台灣，能加強跨院際的資訊流通與跨專科的團隊合作，進而增進病人的醫療成效。

Warfarin is widely used in the prevention and treatment of thromboembolic disorders. In patients receiving anticoagulation treatment, about 10% of them may have surgical or invasive procedures each year. It is important to evaluate the risk of bleeding or thromboembolism with continuing or discontinuing warfarin therapy for the procedures. We report a case with severe brain embolism suspected to be related to prolonged discontinued warfarin treatment and discuss the perioperative warfarin management. We advocate more inter-disciplinary cooperation and communication, and sharing patients' health information among health care settings to improve treatment outcome.