Gastroenterology:直肠镜息肉切除患者无需在术前7天停止氯吡格雷抗血小板治疗

2018-10-29 zhangfan MedSci原创

研究认为接受直肠镜息肉切除患者无需在术前7天停止氯吡格雷抗血小板治疗

现行指南建议在息肉切除术前7天停止使用氯吡格雷以减少出血风险,但该指南的证据十分有限。近日研究人员考察了不间断氯吡格雷治疗是否会增加结肠镜手术患者术后迟发性出血的风险。

选择性结肠镜检并且同期接受氯吡格雷治疗的血管疾病患者参与,患者在结肠镜前7天停止氯吡格雷治疗,随后随机接受每天75mg的氯吡格雷或安慰剂,直至直肠镜检查并在检查结束后恢复治疗。研究的主要终点为在结肠镜检查后30天需住院或介入的息肉切除术后延迟出血,次要终点为息肉切除术后立即出血和结肠镜6个月后的严重心脏血栓事件。

387名患者接受结肠镜检查,其中216人接受息肉切除,氯吡格雷组106人,安慰剂组110人。氯吡格雷组术后延迟出血率为3.8%,安慰剂组为3.6%。组间术后即刻出血(8.5% vs 5.5%)以及长期血管血栓(1.5% vs 2%)事件率差异不显著。

研究认为,接受直肠镜息肉切除患者无需在术前7天停止氯吡格雷抗血小板治疗。

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    2019-10-12 许安
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    2018-10-31 zhouqu_8
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