直接口服抗凝剂用于结肠内镜下粘膜解剖的管理:一个多中心观察性研究
Jun Arimoto1, Ken Ohata2, Jun Tachikawa3
1Department of Gastroenterology, Omori Red Cross Hospital, 4-30-1, Chuo, Tokyo, Ota-Ku, 143-8527, Japan.
Digestive diseases and sciences
|February 10, 2024
概括
直接口服抗凝剂 (DOAC) 在结直肠内镜下粘膜剖析 (ESD) 后没有增加延迟出血. 继续DOAC是安全的,但需要进一步的研究来确认最佳的管理策略.
科学领域:
- 胃肠病学 胃肠病学
- 内镜检查是指内镜检查.
- 药理学 药理学是指药理学的学科.
背景情况:
- 关于在结直肠内镜下粘膜剖析 (ESD) 期间使用直接口服抗凝剂 (DOAC) 的数据有限.
- 评估DOACs对术后出血的影响对于患者安全至关重要.
研究的目的:
- 评估DOAC使用与结直肠ESD后延迟出血 (DB) 发生率之间的关联.
- 为了比较服用DOACs的患者与未服用抗凝剂的患者的DB率.
主要方法:
- 从3515名接受ESD的患者中对3909个结直肠病变进行了回顾性分析.
- 损伤分为无抗凝剂 (无AT) 和DOAC组.
- 在DOAC继续和退出子组之间比较DB率.
主要成果:
- 整体延迟出血 (DB) 率为2.3% (90/3909).
- 在无AT组 (2.2%) 和DOAC组 (3.3%) 之间,DB率没有显著差异.
- DB的独立风险因素包括直肠位置和病变大小≥30毫米.
结论:
- 使用DOAC似乎不会显著增加结肠直肠ESD后延迟出血的速度.
- 建议进行进一步的前性研究,以确定在结直肠ESD之前对DOAC管理的最终指南.
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