在接受抗凝药的患者内透镜缩切除术后延迟出血
Mitsushige Sugimoto1, Masaki Murata2, Kento Shionoya3
1Division of Genome-Wide Infectious Microbiology, Research Center for GLOBAL and LOCAL Infectious Disease, Oita University, Oita, Japan.
概括
在内镜缩切除术 (EST) 后延迟出血是服用抗凝剂的患者的风险. 监测抗凝剂水平,就像对直接口服抗凝剂 (DOACs) 的抗Xa活性一样,可以帮助识别高风险患者.
科学领域:
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
- 心脏病学 心脏病学
背景情况:
- 在内镜缩膜切除术 (EST) 后,延迟出血影响0.5-5%的患者.
- 对心血管疾病增加抗凝剂 (DOAC,华法林) 的使用增加了后EST出血风险.
- 目前的指导方针可能无法完全减轻抗血栓药物使用者的出血风险.
研究的目的:
- 审查抗凝剂使用者的EST后出血的危险因素,指导方针和药理学方面.
- 探索监测抗凝剂效果和识别高风险患者的方法.
- 讨论未来预防EST后出血的方向.
主要方法:
- 文献综述侧重于使用抗凝剂的患者的EST后出血.
- 对抗凝血剂的风险因素,临床指导方针和药理性质的分析.
- 对抗凝血剂作用的新型监测参数的调查.
主要成果:
- 抗凝剂的使用显著增加了后EST出血风险,即使遵循指导方针.
- 对直接口服抗凝剂 (DOAC) 缺乏准确的监测参数.
- 血水平和抗Xa因子活性显示出监测XA因子抑制剂的前景,类似于华法林的PT-INR.
结论:
- 识别高风险患EST后出血的患者至关重要.
- 血水平和抗因子Xa活性可能有助于监测DOAC并识别有风险的个体.
- 未来的研究应该专注于开发风险分层评分系统,用于EST后延迟出血.
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