与肝素相比,在接受减肥手术的患者中,沙的静脉血栓栓塞预防增加了出血风险
Audra J Reiter1,2, Joanne Prinz2, Yan Li2
1Northwestern Quality Improvement, Research, & Education in Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Surgical endoscopy
|June 21, 2023
概括
改变减肥手术的预防方法,从肝素转变为埃诺沙巴林,增加了术后出血. 在这两种抗凝血药物之间,静脉血栓栓塞 (VTE) 发生率仍然相似,这表明埃诺沙巴林的潜在安全问题.
科学领域:
- 腹部外科 腹部外科
- 药理学 药理学是指药理学的学科.
- 血栓形成的管理
背景情况:
- 在外科手术期间的静脉血栓塞栓症 (VTE) 化学预防是减肥手术中的标准.
- 有限的比较数据存在,用于选择氨酸和氧氨酸之间的VTE预防.
研究的目的:
- 为了比较术后出血和VTE发生率,在改变VTE预防从肝素到恩沙巴林在减肥手术患者.
主要方法:
- 对18岁以上接受初级减肥手术 (SG或RYGB) 的患者进行了回顾性队列研究.
- 在静脉瘤预防中使用未分离的肝素 (2012年3月 - 2018年2月),然后使用埃诺沙巴林 (2018年3月 - 2021年12月).
- 术后出血定义为需要在30天内输血或重新手术;用于比较的基平方测试.
主要成果:
- 埃诺沙巴林组 (3.1%) 的术后出血率明显高于肝素组 (0.9%).
- 在埃诺沙巴林组 (0.8%与0.2%) 中,出血的复发也更频繁.
- 在肝素和埃诺沙巴林组之间没有观察到VTE发生的显著差异.
结论:
- 在减肥手术中将静脉瘤预防从肝素转换为埃诺沙巴林与术后出血增加有关.
- 抗凝剂的变化没有影响VTE并发症的发生率.
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