胃肠道手术患者的抗血栓治疗结果:一个元分析
Faryal Tariq1, Hasnain Ali2, Abdul Moeed Baig3
1General Medicine, East Kent Hospitals University NHS Foundation Trust, Margate, GBR.
Cureus
|August 25, 2025
概括
在胃肠道外科手术中,外科手术期间的抗血栓治疗显示出增加出血和显著增加的输血需求的趋势. 谨慎管理至关重要,但需要进一步的试验以获得明确的指导方针.
科学领域:
- 胃肠病学和外科
- 心脏病和血栓形成
- 临床结果研究
背景情况:
- 抗血栓治疗对于血栓塞栓性疾病至关重要,但由于出血和血栓形成的风险,会使胃肠道手术复杂化.
- 在胃肠道手术前期使用抗血栓剂需要平衡出血和凝血风险.
研究的目的:
- 在接受胃肠道手术的患者中评估外科手术期间的抗血栓治疗的临床结果.
- 评估术后出血的风险,血栓塞栓事件以及输血需求.
主要方法:
- 在主要数据库 (PubMed,CENTRAL,Scopus等) 进行系统的文献搜索 遵守PRISMA的指导方针.
- 使用DerSimonian- Laird随机效应模型对9项涉及13,107名患者的研究进行了元分析.
- 主要结局:术后出血,血栓塞栓事件和需要输血.
主要成果:
- 术后出血增加的趋势不显著 (OR:1. 64, p=0. 061).
- 血栓塞栓事件没有显著差异 (OR:0. 91, p=0. 82) 异质性较低.
- 抗血栓治疗组的输血需求显著增加 (OR: 2. 87, p=0. 019).
结论:
- 在胃肠道外科手术中,术后的抗血栓治疗与输血需求的增加有关.
- 在选择性情况下,单独使用阿司匹林可能是安全的,但双重抗血小板治疗和DOAC会增加出血风险.
- 个人风险评估和仔细规划至关重要; 需要进一步的RCT来制定最终的指导方针.
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