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慢性抗凝血治疗患者的腹手术的长期结果
Kamal Abi Mosleh1, Amanda Belluzzi1, Marita Salame1
1Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Obesity surgery
|November 2, 2023
概括
接受慢性抗凝疗 (CAT) 且接受代谢和腹腔外科手术 (MBS) 的患者面临更高的出血风险,特别是在Roux-en-Y胃绕道 (RYGB) 后. 对这些风险的咨询和探索华法林替代品至关重要.
科学领域:
- 腹部外科 腹部外科
- 心脏病学 心脏病学
- 胃肠病学 胃肠病学
背景情况:
- 代谢和减肥手术 (MBS) 涉及大约3%的慢性抗凝疗 (CAT) 患者.
- 管理这些患者需要平衡血栓形成和出血风险.
- 评估MBS后的长期出血风险和抗凝剂剂量是至关重要的.
研究的目的:
- 在接受MBS的患者中评估长期出血风险.
- 分析MBS后抗凝剂剂量的趋势.
主要方法:
- 一项对132名患者 (2008-2022) 的回顾性审查,这些患者接受了Roux-en-Y胃旁路术 (RYGB) 或袖子胃切除术 (SG) 与手术前的CAT.
- 收集的数据包括人口统计,抗凝血指示,类型和剂量.
- 评估了出血事件和同时发生的CAT.
主要成果:
- 长期出血的发生率在RYGB组 (18.3%) 与SG组 (4%) 相比显著更高.
- 在RYGB患者中,出血边缘 (MU) 是最常见的原因 (13.4%).
- 84.2%的出血事件发生在长期接受华法林治疗的患者中.
结论:
- 慢性抗凝疗 (CAT) 增加RYGB患者的出血风险,特别是MU出血.
- 考虑MBS的CAT患者需要就潜在风险进行咨询.
- 直接作用的口服抗凝剂可能为华法林提供更安全的替代品,需要进一步研究.
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