在接受华法林和DOAC手术的患者中,出现出血并发症和二次手术的风险
Hasan Ehsan1, Zainub Abdullah2, Misha F Syed2
1University of Texas Medical Branch, Galveston, TX, USA.
Clinical ophthalmology (Auckland, N.Z.)
|October 9, 2025
概括
与直接口服抗凝剂 (DOACs) 相比,华法林在绿眼镜手术后增加了眼部出血的风险. 然而,抗凝剂的使用并没有使这些患者需要重新手术.
科学领域:
- 眼科医生 眼科 眼科
- 药理学 药理学是指药理学的学科.
- 临床研究 临床研究
背景情况:
- 眼外科手术需要仔细管理抗凝血药物,以尽量减少出血风险.
- 直接口服抗凝剂 (DOAC) 的使用越来越多,需要与华法林进行手术结果的比较.
研究的目的:
- 为了比较手术后眼部出血并发症的发生率,在接受绿眼瘤手术的患者中,他们正在服用华法林与DOACs.
- 评估这些患者群体在出血并发症后重新手术的风险.
主要方法:
- 使用 TriNetX 全球联合健康研究网络进行的回顾性队列研究.
- 倾向性得分匹配被用来比较15 019名华法林患者和15 019名DOAC患者.
- 分析包括多种眼部出血和一年内的再手术率,统计学意义为p < 0.05.
主要成果:
- 与DOACs相比,华法林使用与玻璃体出血,结膜出血,视网膜出血和血风险的增加显著相关.
- 两组之间没有观察到胆管出血或术后米托米辛C注射风险的显著差异.
- 眼部出血并发症并没有提高华法林或DOACs患者重新手术的风险.
结论:
- 华法林与眼睛出血并发症的风险较高,在玻璃眼瘤手术后与DOACs相比.
- 选择抗凝剂 (华法林与DOACs) 并没有影响经过出血并发症后重复手术的风险.
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