现代消化及介入诊疗
現代消化及介入診療
현대소화급개입진료
MODERN DIGESTION & INTERVENTION
2014年
2期
79-81
,共3页
内镜%华法林%出血事件%血栓事件
內鏡%華法林%齣血事件%血栓事件
내경%화법림%출혈사건%혈전사건
Endoscopy%Warfarin%Bleeding%Thromboembolism
目的：探讨高危消化内镜干预对服用华法林患者的临床安全性。方法入选服用华法林同时需行高危内镜操作的患者148例，术后分为早期复用抗凝组73人（术后8 h内恢复抗凝治疗）和延迟复用抗凝组75人（术后第3天恢复抗凝治疗）。比较两组患者出血发生率和血栓发生率。结果两组患者出血事件发生率没有统计学差异（9.59%vs.4.00%，P=0.304），早期恢复抗凝治疗出血风险的OR值为1.28，延迟恢复抗凝血栓事件发生率较高（12.00%vs.2.74%，P=0.031），延迟恢复抗凝血栓风险的OR值为3.83。结论对于服用华法林的患者，高危消化内镜术后8小时内恢复抗凝治疗可以降低血栓发生风险，而出血风险增加相对不明显。
目的：探討高危消化內鏡榦預對服用華法林患者的臨床安全性。方法入選服用華法林同時需行高危內鏡操作的患者148例，術後分為早期複用抗凝組73人（術後8 h內恢複抗凝治療）和延遲複用抗凝組75人（術後第3天恢複抗凝治療）。比較兩組患者齣血髮生率和血栓髮生率。結果兩組患者齣血事件髮生率沒有統計學差異（9.59%vs.4.00%，P=0.304），早期恢複抗凝治療齣血風險的OR值為1.28，延遲恢複抗凝血栓事件髮生率較高（12.00%vs.2.74%，P=0.031），延遲恢複抗凝血栓風險的OR值為3.83。結論對于服用華法林的患者，高危消化內鏡術後8小時內恢複抗凝治療可以降低血栓髮生風險，而齣血風險增加相對不明顯。
목적：탐토고위소화내경간예대복용화법림환자적림상안전성。방법입선복용화법림동시수행고위내경조작적환자148례，술후분위조기복용항응조73인（술후8 h내회복항응치료）화연지복용항응조75인（술후제3천회복항응치료）。비교량조환자출혈발생솔화혈전발생솔。결과량조환자출혈사건발생솔몰유통계학차이（9.59%vs.4.00%，P=0.304），조기회복항응치료출혈풍험적OR치위1.28，연지회복항응혈전사건발생솔교고（12.00%vs.2.74%，P=0.031），연지회복항응혈전풍험적OR치위3.83。결론대우복용화법림적환자，고위소화내경술후8소시내회복항응치료가이강저혈전발생풍험，이출혈풍험증가상대불명현。
Objective To investigate clinical safety of high-risk endoscopic procedures in patients re-ceiving anticoagulation therapy. Methods One hundred and forty-eight patients receiving anticoagulation therapy were enrolled in this study. After high-risk endoscopic procedures which were necessary for each pa-tient, eligible patients were divided into early anticoagulation group (n=73) and delayed anticoagulation group (n=75). Early anticoagulation group recovered anticoagulation therapy within 8 hours after procedures, and delayed anticoagulation group recovered anticoagulation therapy on the 3rd day after procedures. Risk of bleeding and risk of thromboembolism were observed to evaluate the clinical safety. Results The rate of bleeding was similar between the two groups (9.59%vs. 4.00%, P=0.304), but the rate of thromboembolism was higher in delayed anticoagulation group compared with early anticoagulation group (12.00%vs. 2.74%, P=0.031). Early anticoagulation therapy increased the risk of bleeding (OR=1.48), and delayed anticoagulation therapy increased the risk of thromboembolism (OR=3.83). Conclusions For patients receiving anticoagula-tion therapy within 8 hours after high-risk endoscopic procedures can reduce the risk of thromboembolism, with inconspicuous increase of bleeding risk.
