在接受抗血栓治疗的患者中食道扩张手术的安全性:美国协作网络队列研究
Khaled Elfert1, Abdellatif Ismail2, Mohammed Abusuliman3
1Division of Gastroenterology, West Virginia University School of Medicine, Morgantown, WV, USA.
The American journal of gastroenterology
|August 20, 2025
概括
接受食道扩张的抗凝药患者面临更高的胃肠道出血风险. 双抗血小板疗法也显示出增加出血的趋势,尽管在统计学上并不显著.
科学领域:
- 胃肠病学
- 心脏病学
- 临床医学
背景情况:
- 在使用抗血栓药物的患者中,食道扩张是常见的.
- 在食道扩张期间与抗血栓治疗相关的出血风险尚未确定.
研究的目的:
- 在服用抗凝剂或双抗血小板治疗 (DAPT) 期间接受食道扩张的患者中评估术后胃肠道出血的风险.
主要方法:
- 使用 TriNetX 美国协作网络数据库进行回顾性倾向匹配的队列研究.
- 在食道扩张后30天内评估抗凝剂和DAPT对胃肠道出血的影响.
主要成果:
- 使用抗凝剂显著增加了手术后胃肠道出血的风险 (RR,1. 43;95% CI,1. 06-1. 92),输血和重症监护室入院率更高.
- 双抗血小板治疗 (DAPT) 显示肠道出血的风险较高 (RR,1. 64;95% CI,0. 97-2. 75),但没有达到统计学意义.
- 早期恢复抗血栓治疗并没有增加出血风险.
结论:
- 抗凝药治疗与食道扩张后出血的风险增加有关.
- DAPT可能会增加出血风险,但需要进一步的研究来确认统计学意义.
- 结果可以指导临床决策关于食道扩张手术的抗血栓治疗.
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