Platelet transfusion prevents the perioperative bleeding in patients with antiplatelet therapy-associated cerebral hemorrhage / 中国神经精神疾病杂志

ABSTRACT

Objective To explore the application value of thromboelastography(TEG) in perioperative evaluation of patients with antiplatelet therapy-associated cerebral hemorrhage. We aimed to investigate whether platelet transfu-sion, compared with standard care, reduced bleeding in patients with antiplatelet therapy-associated cerebral hemor-rhage. Methods A retrospective analysis of clinical data was conducted in 30 patients (12 patients receiving platelet transfusion) with antiplatelet therapy-associated basal ganglia hemorrhage who underwent emergency surgery. TEG was used to evaluate the intraoperative bleeding, postoperative bleeding and transfusion treatment. Results The routine co-agulation test was in the normal range in the two groups. However, TEG showed that the platelet function was exces-sively inhibited in patients with antiplatelet therapy before spontaneous cerebral hemorrhage (Platelet inhibition rate>90%). There were significant differences in the intraoperative blood loss (t=-3.998, P=0.008), total transfusion volume (Z=-3.245, P=0.001), postoperative hematoma volume (t=-2.909, P=0.043) and lead volume (t=-8.790, P=0.041) between two groups (P<0.05). One case from platelet transfusion group, and 4 cases from no-platelet transfusion group re-ceived a second surgical operation. However, the difference was not statistical significant ( P=0.317). Conclusion TEG can effectively assess the preoperative coagulation status in the patients with spontaneous cerebral haemorrhage after antiplatelet therapy. Platelet transfusion can reduce intraoperative and postoperative bleeding, decrease blood transfu-sion in the patients with antiplatelet therapy-associated cerebral hemorrhage.