抗血栓药物对皮肤内镜胃口术术术后结果的影响:美国协作网络研究
Khaled Elfert1, Mohammed Abusuliman2, Hossam Elbenawi3
1Division of Gastroenterology, West Virginia University School of Medicine, Morgantown, West Virginia.
European journal of gastroenterology & hepatology
|May 13, 2025
概括
通过皮肤内镜胃口术 (PEG) 持续抗凝剂可能会增加轻微出血的风险,但不是严重出血. 继续双抗血小板治疗 (DAPT) 没有显著增加出血,有助于PEG患者的管理决策.
科学领域:
- 胃肠病学 胃肠病学
- 心脏病学 心脏病学
- 临床医学 临床医学
背景情况:
- 穿皮内镜胃口术 (PEG) 对于无法口服饮食的患者的长期肠道营养至关重要.
- 接受抗凝或双抗血小板治疗 (DAPT) 的患者在PEG手术期间面临更高的出血风险.
- 在PEG安置期间管理抗血栓治疗对于平衡出血和血栓风险至关重要.
研究的目的:
- 评估在PEG手术期间持续抗凝剂的出血风险.
- 在接受PEG安置的患者中评估持续DAPT的安全性.
- 为了比较不同抗血栓治疗方案的患者之间的出血结果.
主要方法:
- 来自TriNetX美国协作网络数据库的四个队伍的分析.
- 包括服用抗凝血剂,不服用抗凝血剂,DAPT和阿司匹林 (ASP) 的患者.
- 专注于7日和30日的胃口相关出血,其次要结果包括死亡率和输血或重新干预的需要.
主要成果:
- 抗凝剂组和没有抗凝剂组之间7天出血风险没有显著差异.
- 在抗凝固剂组 (0.9%对0.4%,P=0.007) 观察到更高的30天出血风险.
- 在严重出血事件,死亡率或需要输血/重新干预方面没有显著差异. 与阿司匹林相比,继续使用DAPT并没有显著增加出血风险.
结论:
- 抗凝剂的使用可能会增加PEG后轻微出血,但不会增加严重出血事件.
- 在PEG放置期间继续使用DAPT与出血风险的统计学上显著增加无关.
- 这些发现为接受PEG手术的患者进行抗血栓治疗的管理提供了指导.
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