内镜下大肠息肉切除术围术期抗栓药物的应用

Application of antithrombotic drugs during perioperative period of colonoscopic polypectomy

内镜下大肠息肉切除术有一定的出血风险,抗栓药物是危险因素之一。目前,越来越多的手术患者正在口服抗栓药物,中断抗栓治疗无疑可以有效降低出血风险,但相应也会增加停药后血栓栓塞事件的风险。因此,具体评估每个患者术前状态、进行围手术期抗栓药物管理尤为重要。本综述回顾日本胃肠内镜学会(JGES)、美国胃肠内镜学会(ASGE)、英国胃肠病学会和欧洲胃肠内镜学会(BSG/EGSE)、亚太胃肠病学会和亚太太平洋学会(APAGE/APSDE)等发布的抗栓药物管理指南,并分析来自文献的最新证据,评估接受抗栓治疗的患者在内镜下大肠息肉切除术时的出血和栓塞风险。

Colonoscopic polypectomy has a certain risk of bleeding,and antithrombotic drugs are one of the risk factors.At present,more and more surgical patients are taking antithrombotic drugs.Interruption of antithrombotic therapy can undoubtedly reduce the risk of bleeding,but it will also increase the risk of thromboembolism after drug withdrawal.Therefore,it is particularly important to evaluate the preoperative status of each patient and the management of perioperative antithrombotic drugs.This paper reviews the antithrombotic drug management guidelines issued by the Japan Gastroenterological Endoscopy Society(JGES),the American Society for Gastrointestinal Endoscopy(ASGE),the British Society of Gastroenterology(BSG),the European Society of Gastrointestinal Endoscopy(ESGE),the Asian Pacific Association of Gastroenterology(APAGE),and the Asian Pacific Society for Digestive Endoscopy(APSDE),and analyzes the latest evidence from the literature to assess the risk of bleeding and embolism during colonoscopic polypectomy in patients receiving antithrombotic therapy.