GUT:胃肠道内镜治疗前的抗凝血管理

2018-08-01 zhangfan MedSci原创

研究发现,内镜下胃肠道治疗出血风险较高的患者应依据BSG/ESGE指南暂停抗凝药物治疗

近日研究人员考察英国胃肠病学会(BSG)和欧洲胃肠镜学会(EGE)关于胃肠道内镜治疗患者抗凝血管理方案的效果。

正在接受口服抗凝药物(DOACs),准备进行胃肠道内镜检查或治疗的患者参与研究。依据患者的治疗手段及胃肠道出血风险进行分层。研究的主要终点为30天主要及临床相关非主要出血事件(CRNMB)的发生率、动脉-静脉血栓栓塞和死亡。

529名患者参与研究,其中38%的患者出血风险较高,62%患者出血风险较低,总计发生45起出血事件(8.5%; 95% CI 6.3%-11.2%) 以及2起血栓栓塞事件(0.4%; 95% CI 0%-1.4%)。低风险人群出血事件发生率为1.8%,而高风险人群为19.3%。高风险人群中,根据BSG/ESGE指南或提前中断抗凝的患者,组间术中出血率相似的(10.3%vs10.8%, p=0.99),与停止抗凝治疗较晚的患者相比,其出血风险降低(10.3% vs 25%, p=0.07)。根据BSG/ESGE指南或提前中断抗凝的患者,组间延迟出血率相似(6.6% vs 7.7%, p=0.76),而过早恢复抗凝治疗导致延迟出血风险增加(14.4% vs 6.6%, p=0.27)。研究发现,接受肝素桥接患者严重延迟出血风险显著增加(26.6%vs5.9%, p=0.017)。

研究发现,内镜下胃肠道治疗出血风险较高的患者应依据BSG/ESGE指南暂停抗凝药物治疗。

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    2019-04-20 ann y

    内镜下胃肠道治疗出血风险较高的患者应依据BSG/ESGE指南暂停抗凝药物治疗。

    0

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    2019-04-18 ann y

    胃肠道疾病的诊治离不开消化内镜

    0

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    2018-08-01 易水河

    知之为知之,学习学习

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=365002, encodeId=270636500228, content=内镜下胃肠道治疗出血风险较高的患者应依据BSG/ESGE指南暂停抗凝药物治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRrYOibkVibW9vAkCfb2F55aHjqMoqUVaF9fuXIMCxexawSOsicpbF7Ria7o54zPK65PodlkwhPrNhLhS/0, createdBy=12f71314239, createdName=ann y, createdTime=Sat Apr 20 23:56:32 CST 2019, time=2019-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=364871, encodeId=19a83648e1cc, content=胃肠道疾病的诊治离不开消化内镜, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRrYOibkVibW9vAkCfb2F55aHjqMoqUVaF9fuXIMCxexawSOsicpbF7Ria7o54zPK65PodlkwhPrNhLhS/0, createdBy=12f71314239, createdName=ann y, createdTime=Thu Apr 18 23:49:17 CST 2019, time=2019-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1262001, encodeId=bd1f12620016e, content=<a href='/topic/show?id=0ceb30545e0' target=_blank style='color:#2F92EE;'>#内镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30545, encryptionId=0ceb30545e0, topicName=内镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Thu Aug 02 21:25:00 CST 2018, time=2018-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1346260, encodeId=580c1346260e5, content=<a href='/topic/show?id=339e8332035' target=_blank style='color:#2F92EE;'>#胃肠道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83320, encryptionId=339e8332035, topicName=胃肠道)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e03212, createdName=liao1619, createdTime=Thu Aug 02 21:25:00 CST 2018, time=2018-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1440682, encodeId=f9a0144068223, content=<a href='/topic/show?id=4f7a30582c3' target=_blank style='color:#2F92EE;'>#内镜治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30582, encryptionId=4f7a30582c3, topicName=内镜治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d9014754625, createdName=644982816_68283322, createdTime=Thu Aug 02 21:25:00 CST 2018, time=2018-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335553, encodeId=c6613355533a, content=知之为知之,学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Wed Aug 01 14:51:31 CST 2018, time=2018-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335483, encodeId=79fb335483f4, content=学习了,长知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Wed Aug 01 08:29:22 CST 2018, time=2018-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335471, encodeId=2c703354e164, content=好,学习学习。, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/07/16/3b24606172648eea459125cb74754afe.jpg, createdBy=6c022216608, createdName=liumin1987, createdTime=Wed Aug 01 07:40:14 CST 2018, time=2018-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335469, encodeId=a3cd33546913, content=学习了,有用的研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=73441710184, createdName=明崖, createdTime=Wed Aug 01 07:30:20 CST 2018, time=2018-08-01, status=1, ipAttribution=)]
    2018-08-01 1ddf0692m34(暂无匿称)

    学习了,长知识

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=365002, encodeId=270636500228, content=内镜下胃肠道治疗出血风险较高的患者应依据BSG/ESGE指南暂停抗凝药物治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRrYOibkVibW9vAkCfb2F55aHjqMoqUVaF9fuXIMCxexawSOsicpbF7Ria7o54zPK65PodlkwhPrNhLhS/0, createdBy=12f71314239, createdName=ann y, createdTime=Sat Apr 20 23:56:32 CST 2019, time=2019-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=364871, encodeId=19a83648e1cc, content=胃肠道疾病的诊治离不开消化内镜, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRrYOibkVibW9vAkCfb2F55aHjqMoqUVaF9fuXIMCxexawSOsicpbF7Ria7o54zPK65PodlkwhPrNhLhS/0, createdBy=12f71314239, createdName=ann y, createdTime=Thu Apr 18 23:49:17 CST 2019, time=2019-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1262001, encodeId=bd1f12620016e, content=<a href='/topic/show?id=0ceb30545e0' target=_blank style='color:#2F92EE;'>#内镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30545, encryptionId=0ceb30545e0, topicName=内镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Thu Aug 02 21:25:00 CST 2018, time=2018-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1346260, encodeId=580c1346260e5, content=<a href='/topic/show?id=339e8332035' target=_blank style='color:#2F92EE;'>#胃肠道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83320, encryptionId=339e8332035, topicName=胃肠道)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e03212, createdName=liao1619, createdTime=Thu Aug 02 21:25:00 CST 2018, time=2018-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1440682, encodeId=f9a0144068223, content=<a href='/topic/show?id=4f7a30582c3' target=_blank style='color:#2F92EE;'>#内镜治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30582, encryptionId=4f7a30582c3, topicName=内镜治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d9014754625, createdName=644982816_68283322, createdTime=Thu Aug 02 21:25:00 CST 2018, time=2018-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335553, encodeId=c6613355533a, content=知之为知之,学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Wed Aug 01 14:51:31 CST 2018, time=2018-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335483, encodeId=79fb335483f4, content=学习了,长知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Wed Aug 01 08:29:22 CST 2018, time=2018-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335471, encodeId=2c703354e164, content=好,学习学习。, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/07/16/3b24606172648eea459125cb74754afe.jpg, createdBy=6c022216608, createdName=liumin1987, createdTime=Wed Aug 01 07:40:14 CST 2018, time=2018-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335469, encodeId=a3cd33546913, content=学习了,有用的研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=73441710184, createdName=明崖, createdTime=Wed Aug 01 07:30:20 CST 2018, time=2018-08-01, status=1, ipAttribution=)]
    2018-08-01 liumin1987

    好,学习学习。

    0

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    2018-08-01 明崖

    学习了,有用的研究

    0

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