緒言とまとめ

Perioperative Coagulation Management；Up-to-Date：Preface and Comments

　近年，脳血管障害，肺血栓塞栓症，心房細動などの併発病態をもつ患者が増加しており，術前抗凝固薬を服用している患者が手術を受ける機会は今後さらに増加することが予測される。また，手術中の大量出血に対する適切な対応は依然として重要な課題である^1）2）。特に経口抗凝固薬およびその拮抗薬，濃縮凝固因子製剤に関しては新たな薬物が使用されており，これらに関する最新の情報を整理しておくことは有意義と考えた。

　The number of individuals with comorbidities such as cerebrovascular disease, pulmonary thromboembolism, and atrial fibrillation is increasing, and the number of patients undergoing surgery while taking preoperative anticoagulants is expected to continue to rise. In addition, the appropriate management of massive bleeding during surgery remains a critical challenge. New oral anticoagulants, their antagonists, and concentrated coagulation-factor products are increasingly used. A compilation of the latest information on these agents is thus desirable. In this special issue, anticoagulants and coagulation-factor products, concentrated fibrinogen preparations, concentrated prothrombin complex preparations, and recombinant active factorⅦpreparations are summarized.

　In the clinical section, the latest findings in cases requiring careful coagulation management―such as open-heart surgery, childbirth/cesarean section, and head trauma and intracranial bleeding―are presented by specialists. The latest findings regarding the management of perioperative coagulation are also summarized. Due to space limitations, this thematic series does not cover regional anesthesia in patients who are on anticoagulant therapy or coagulation abnormalities and their management in sepsis patients. For the latest reviews on these topics, please refer to the following references.