在患有与口服抗凝剂相关的胃肠道出血的患者中,通过皮肤进行左心房附属器关闭
Patricia Sanz Segura1, Javier Jimeno Sánchez2, José Miguel Arbonés-Mainar3,4,5
1Gastroenterology Department, Royo Villanova Hospital, Zaragoza, Spain.
Scandinavian journal of gastroenterology
|July 25, 2023
概括
通过皮肤进行的左心房尾关闭 (LAAC) 显著减少了心房动患者的胃肠道出血和慢性贫血. 这种程序还导致医疗保健资源利用率大幅减少,为口服抗凝药提供了安全的替代方案.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 胃肠病学 胃肠病学
背景情况:
- 心房动 (AF) 患者通常需要口服抗凝剂 (OAC) 来预防中风.
- OAC与胃肠道出血 (GIB) 和慢性贫血的风险增加有关.
- 左心房尾关闭 (LAAC) 是AF中另一种脑卒中预防策略.
研究的目的:
- 评估皮肤穿的LAAC在减少AF患者的GIB和慢性贫血中的有效性.
- 评估与OAC相比,LAAC对医疗保健资源消费的影响.
- 在特定患者群体中确定LAAC作为OAC替代品的安全性.
主要方法:
- 从2016年到2022年进行的前性单中心研究.
- 在LAAC之前和6个月后收集的临床,分析和医疗保健资源数据 (内镜,输血,住院治疗).
- 包括43名患者 (平均年龄为77.6岁),由于GIB而导致LAAC的征兆.
主要成果:
- 拉克显著减少了红细胞输血 (7.29到0.42每名患者,p<0.001).
- 在LAAC后,内镜手术和住院病例急剧下降 (p < 0.001).
- 平均血红蛋白水平显著改善 (8.1至12.4g/dL,p<0.001),没有报告的血栓栓塞事件.
结论:
- 穿皮LAAC是一种安全有效的替代OAC的AF患者显著的GIB.
- 拉克可以解决慢性贫血,减少对输血和住院治疗的需求.
- 这种干预措施在医疗保健资源利用方面可以大大节省成本.
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