在接受选择性胃肠内镜检查的直接口服抗凝剂患者的周围程序管理
Christopher Hansen-Barkun1, Myriam Martel1, Alan N Barkun2
1Research Institute of the McGill University Health Center, Montreal, Quebec, Canada
Polish archives of internal medicine
|June 28, 2024
概括
对于接受内镜检查的直接口服抗凝剂 (DOAC) 患者,最少的DOAC中断通常是安全的. 目前的指导方针支持避免大多数程序的肝素桥接,简化管理.
科学领域:
- 胃肠病学 胃肠病学
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 直接口服抗凝剂 (DOAC) 越来越多地用于血栓塞栓预防.
- 消化内镜是一种常见的手术,具有固有的出血风险.
- 管理DOACs周内镜需要平衡出血和凝结风险.
研究的目的:
- 审查关于消化内镜周围手术DOAC管理的当前文献.
- 分析与DOAC和内镜手术相关的血栓栓塞和出血风险.
- 总结主要胃肠道学会关于DOAC管理的指导方针.
主要方法:
- 现有文献的叙述性审查.
- 分析程序特定的出血风险.
- 评估用于缓解出血的过程内技术.
- 围绕程序的DOAC指南的综合.
主要成果:
- 文献支持大多数内镜手术中最少的DOAC中断.
- 肝素桥梁往往是不必要的,减少出血的风险和复杂性.
- 风险分层模型有助于围绕程序的决策.
结论:
- 当代实践有利于在接受消化内镜检查的患者中最少的DOAC中断.
- 避免肝素桥接简化了管理,减少了并发症.
- 进一步的研究可以完善风险分层和管理策略.
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