结肠息肉切除术在服用抗血栓药物患者中的安全性与有效性

Safety and efficacy of colon polypectomy in patients taking antithrombotic drugs

目的探讨结肠息肉切除术在服用抗血栓药物患者中的安全性及有效性。方法回顾性分析2022年8月至2023年8月在中国医学科学院阜外医院消化内科行结肠息肉切除术不间断服用抗血栓药物治疗的患者,对抗血栓药物的种类、切除息肉的部位、长径、术后迟发性出血、穿孔、切除的完整性,术后缺血性事件发生等进行统计分析。结果研究共纳入息肉103例,根据息肉直径是否>10 mm,分成两组(小息肉组87例vs大息肉组16例),两组中息肉部位、形态、服用抗血栓药物的种类、治愈性切除率、术后出血事件发生率、术后缺血事件发生率中组间均无显著统计学差异;大息肉组更多的选择EMR治疗(小息肉组vs大息肉组,4.6%vs 45.5%,P=0.004);术后的病理大息肉组更多腺瘤性息肉(77.0%vs 93.8%,P=0.027)。结论结肠息肉切除术可安全、有效应用于不间断服用抗血栓药物的患者。

Objective To investigate the safety and effectiveness of colon polypectomy in patients taking antithrombotic drugs.Methods Polyps treated with endoscopic polypectomy at the Department of Gastroenterology,Fu Wai Hospital,Chinese Academy of Medical Sciences,from August 2022 to August 2023 were retrospectively analyzed for the site of polyp,postoperative delayed hemorrhage,perforation,and the completeness of resection,specimen retrieval,and the occurrence of postoperative ischemic events.Results A total of 103 polyps were included in the study,which were divided into two groups according to whether the diameter of the polyp was>10 mm(87 cases in the small polyp group vs 16 cases in the large polyp group),and there was no statistically significant difference between the two groups in terms of the site of the polyp,its morphology,the type of antithrombotic drug taken,the rate of curative resection,the rate of postoperative hemorrhagic events,and the incidence of postoperative ischemic events;the large polyp group chose more often to undergo EMR treatment(small polyp group vs.large polyp group,4.6%vs.45.5%,P=0.004);postoperative pathology was more adenomatous polyps in the large polyp group(small polyp group vs.large polyp group,77.0%vs.93.8%,P=0.027).Conclusion Endoscopic polypectomy can be used safely and effectively in patients taking antithrombotic drugs.