抗血栓剂和小肠出血的管理 - 现在是时候把谨慎放到风中了吗?
Lucia Scaramella1, Agostino Cosenza2, Cristina Romero-Mascarell3
1Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Current opinion in gastroenterology
|February 17, 2026
概括
在接受抗血栓治疗的患者中,小肠出血 (SBB) 的管理是具有挑战性的. 虽然继续使用抗血栓剂有助于诊断,但指导方针通常建议停止使用它们进行内镜治疗,从而造成临床实践的差距.
科学领域:
- 胃肠病学 胃肠病学
- 内镜检查是指内镜检查.
- 内部医学 内部医学
背景情况:
- 小肠出血 (SBB) 越来越令人担忧,部分原因是抗血栓治疗的使用增加.
- 在服用抗凝血剂或抗血小板剂的患者中,管理SBB带来了独特的诊断和治疗挑战.
研究的目的:
- 对接受抗血栓治疗的患者内镜治疗SBB的当前前前景进行审查.
- 评估在SBB管理期间对抗血栓治疗的传统谨慎方法是否应该重新考虑.
主要方法:
- 对接受抗血栓剂的患者的小肠囊内镜 (SBCE) 和设备辅助肠镜 (DAE) 的最新研究的综述.
- 在抗血栓治疗的背景下,分析诊断产量和治疗结果.
主要成果:
- 在服用抗血栓剂的患者中,SBCE显示出更高的诊断产量.
- 血管病变是SBB的日益严重的原因.
- DAE是治疗的标准,但再出血率仍然很高.
结论:
- 目前,在接受抗血栓剂治疗的患者中,内镜治疗SBB的水平尚不理想.
- 在证据支持持续抗血栓治疗的诊断和建议停止治疗的指导方针之间存在差异.
- 需要进一步的前性研究和专家共识,以优化这种患者群体的SBB管理.
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