在使用抗血栓药物患者的皮肤内镜胃口术后出现出血的风险
Yavuz Emre Parlar1, Fuad Mustafayev2, Cavanşir Vahabov2
1Department of Gastroenterology, Hacettepe University, Ankara, Turkey.
概括
服用抗血栓性 (AT) 药物的患者在经皮内镜胃口术 (PEG) 后有较高的出血风险,尽管基于指导方针的中止. 密切监测PEG后的患者至关重要,即使在遵循AT药物协议时也是如此.
科学领域:
- 胃肠病学 胃肠病学
- 心脏病学 心脏病学
- 老年病的医生 老年病的医生
背景情况:
- 抗血栓性 (AT) 药物的使用在经过皮肤内镜胃口术 (PEG) 的患者中很常见.
- 遵守欧洲社会胃肠内镜指南在PEG之前停止使用AT药物是标准做法.
- 该研究调查了与PEG患者使用AT药物相关的出血风险.
研究的目的:
- 根据既定指南,评估在停止服用AT药物的患者中PEG后出血的发生率.
- 为了比较服用AT药物的患者和接受PEG的非AT药物的患者之间的出血率.
- 评估特定的AT药物是否会在PEG后带来不同的出血风险.
主要方法:
- 在2018-2021年期间接受PEG治疗的243名接受AT药物治疗的患者和206名不接受AT药物治疗的患者的回顾性分析.
- 血液出血是由包括输血的需要,血,黑色素,血红蛋白减少或PEG部位出血在内的标准来定义的.
- 收集了有关AT药物使用,停药协议和出血事件的患者数据.
主要成果:
- 与未服用AT药物的患者相比,服用AT药物的患者出血率明显高 (P=0.007).
- 在单独比较时,不同类型的AT药物之间没有观察到出血风险的显著差异.
- 14名患者发生轻微出血事件 (PEG部位出血,黑色素),通过上腺素注射进行保守管理;没有报告输血或死亡.
结论:
- 根据指导方针停止服用AT药物并不能消除PEG后出血的风险.
- 服用AT药物的患者需要对PEG后出血进行警监测,无论他们是否遵守指南.
- 这些发现强调了针对接受抗血栓治疗的PEG患者量身定制的随访方案的重要性.
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