高危消化内镜干预对抗凝治疗患者的临床安全性研究

Safety Study of High-risk Endoscopic Procedures in Patients Receiving Anticoagulation Therapy

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,术后分为早期抗凝组73人(术后8h内恢复抗凝治疗)和延迟抗凝组75人(术后第3 d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差异无统计学意义(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,延迟抗凝组血栓事件发生率较高(12.00%vs.2.74%,P=0.031),延迟抗凝血栓风险的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 h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。

Objective Explore the high-risk intervention digestive endoscopy in patients taking warfarin clinical safety. Methods Selected patients taking warfarin while high-risk endoscopic procedures require line of 148 cases,divided into early postoperative anticoagulation group of 73 people（ resume anticoagulation therapy after surgery 8h） and delayed anticoagulation group of 75 people（ after the first three days resume anticoagulation therapy）. Comparison of the two groups of patients the incidence of bleeding and thrombosis. Results Two groups of patients the incidence of bleeding events was no significant difference（ 9. 59% vs. 4. 00%,P = 0. 304）,the risk of bleeding early recovery anticoagulant therapy OR = 1. 28,delays anticoagulant higher incidence of thromboembolic events（ 12.00 % vs. 2. 74%,P = 0. 031）,delayed anticoagulant thrombosis risk OR = 3. 83. Conclusion For patients taking warfarin,the risk of digestive endoscopy postoperative recovery within eight hours of anticoagulant therapy can reduce the risk of thrombosis,and an increased risk of bleeding is relatively obvious.