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[接受抗栓治疗患者的急性胃肠道出血]

[Acute gastrointestinal bleeding in patients with antithrombotic therapy].

作者信息

Udvardy Miklós, Palatka Károly, Tornai István, Altorjay István

机构信息

Debreceni Egyetem, Orvos- és Egészségtudományi Centrum, Orvostudományi Kar, II. Belgyógyászati Klinika.

出版信息

Orv Hetil. 2002 Jan 27;143(4):183-7.

Abstract

Approximately one-fifth of the patients, referred to the acute gastrointestinal bleeding unit took antithrombotic drugs (anticoagulants and antiplatelet agents) in a dose or with an effect, which made the causal relationship with acute bleeding episodes unequivocal. This paper analyzes the data of the first 100 such patients of the ward. The majority used acethyl-salicylic acid derivatives, however, a substantial number were on coumarol, and some bleeding patients with prosthetic heart valves were also observed. Haemostasis was forced by urgent, accurate, intervention based endoscopy along with simultaneous rapid efforts to correct the underlying clotting abnormalities. Prosthetic valve patients needed special care and attendance, and the reinstitution of anticoagulant treatment as soon as possible to maintain valve patency. The experiences and schedules of the authors, as well as the proposals of the literature are reviewed and summarized.

摘要

转诊至急性胃肠道出血科的患者中,约五分之一服用了抗血栓药物(抗凝剂和抗血小板药物),其剂量或效果使与急性出血事件的因果关系明确。本文分析了该病房首批100例此类患者的数据。大多数患者使用乙酰水杨酸衍生物,然而,相当一部分患者使用香豆素,并且还观察到一些人工心脏瓣膜出血患者。通过紧急、准确的内镜干预以及同时迅速努力纠正潜在的凝血异常来促进止血。人工瓣膜患者需要特殊护理和照料,并尽快重新开始抗凝治疗以维持瓣膜通畅。回顾并总结了作者的经验和方案以及文献中的建议。

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