是十分重要的[16]。对风心病并发脑栓塞的病人，原则上应尽早进行心瓣膜置换术，在脑栓塞后2个月手术为宜。围术期一般不用抗凝剂，但绝对禁用止血剂。体外循环低温灌注时应避免高灌注压和极度血液稀释，防止脑出血和脑水肿。对2个月以上的脑栓塞，适当减少肝素的用量，以防止颅内出血[17]。一旦有颅内出血立即停用抗凝剂，用维生素K及鲜冻血浆等治疗，如果血肿不大，可保守治疗，反之因血肿大，有意识障碍或有脑疝形成，应尽快手术清除血肿[18]。 参考文献
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