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中华胸部外科电子杂志 ›› 2022, Vol. 09 ›› Issue (04) : 255 -263. doi: 10.3877/cma.j.issn.2095-8773.2022.04.10

综述

胸外科术前基础疾病的药物管理
殷怡维1, 焦正1,(), 方文涛2,()   
  1. 1. 200030 上海,上海市胸科医院(上海交通大学附属胸科医院)药剂科
    2. 200030 上海,上海市胸科医院(上海交通大学附属胸科医院)胸外科
  • 收稿日期:2022-03-09 修回日期:2022-08-11 接受日期:2022-10-17 出版日期:2022-11-28
  • 通信作者: 焦正, 方文涛

Medications management of preoperative basic diseases in thoracic surgery

Yiwei Yin1, Zheng Jiao1,(), Wentao Fang2,()   

  1. 1. Department of Pharmacy, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China
    2. Department of thoracic surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China
  • Received:2022-03-09 Revised:2022-08-11 Accepted:2022-10-17 Published:2022-11-28
  • Corresponding author: Zheng Jiao, Wentao Fang
引用本文:

殷怡维, 焦正, 方文涛. 胸外科术前基础疾病的药物管理[J]. 中华胸部外科电子杂志, 2022, 09(04): 255-263.

Yiwei Yin, Zheng Jiao, Wentao Fang. Medications management of preoperative basic diseases in thoracic surgery[J]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2022, 09(04): 255-263.

胸外科手术患者的术前慢性疾病用药管理是围手术期的重要问题,应充分考虑患者的治疗需求和药物相关的手术风险,以确保术前药物的合理使用和患者安全。现有的管理策略大多基于其他类型外科手术的指南或专家意见,缺乏胸外科手术相关的高质量临床研究和总结。本文介绍了已报道的相关临床研究、临床指南及专家共识,总结了胸外科手术患者的术前常用药物的管理策略,包括抗血栓药物、抗高血压药物、降糖药物、呼吸和神经系统药物等,以期为胸外科术前的慢性疾病药物管理提供参考,并为未来的研究提供思路。

Perioperative medication management is important for patients with chronic diseases undergoing thoracic surgery. To ensure optimal medication use preoperatively, chronic disease medication management strategies need to consider both clinical needs of patients and surgical risks associated with medications use. At present, perioperative medication management strategies for thoracic surgery patients are mainly based on guidelines and expert opinions for general surgery, which include limited evidence from randomized trials. Few resources summarized the perioperative medication management strategies specific to thoracic surgery. According to the current literature, this paper summarized strategies for managing common chronic disease medications including antiplatelet, anticoagulant, antihypertensive, diabetes, respiratory, and neurological drugs prior to thoracic surgery. This article also introduced the related clinical studies, clinical guidelines, and expert consensus. This article can serve as a reference for perioperative medication management in patients undergoing thoracic surgery and also provide insight into areas that require future research.

表1 术前抗血小板药物管理推荐[4,5,6,7,8,9,10]
表2 术前抗凝药物管理推荐[5,10,15,16,17,18,19]
表3 术前抗高血压及抗心律失常药物管理推荐[20,21]
表4 术前降糖药物管理推荐[26,27,28,29,30,31]
表5 术前呼吸系统相关药物管理推荐[32,33]
表6 术前神经系统相关药物管理推荐[34,35,36]
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