脳動脈瘤術後管理における血小板凝集抑制剤開始のタイミング

-経時的血小板凝集能計測の重要性-

抄録

We chronologically measured the platelet aggregations in 28 cases after surgery of cerebral aneurysm. Thirteen cases were constantly in normal or slightly increased range of platelet aggregability, and 15 cases showed significant increases. These latter cases evidenced arterial spasm in the course but no spasm in a few cases. Platelet aggregation inhibitors were administrated to the cases that showed increased platelet aggregability. After administration of these drugs, the platelet aggregabilities immediately decreased. Then we tried to control aggregations within the normal or slightly inhibited range. There were no complications by means of bleeding associated with administration of these drugs.
It seems to be a common practice to administrate the platelet aggregation inhibitors after aneurysm surgery. In our study, some of the patients did not show increased platelet aggregability through the postoperative course, so it might not be necessary to give platelet aggregation inhibitors to these patients. Therfore, it is important to measure the platelet aggregation chronologically to decide whether to administer platelet aggregation inhibitors. Platelet aggregation should be controlled within the suitable ranges of platelet aggregability if these drugs are administrated in the postoperative aneurysm patients.