接受抗血栓预防治疗的患者行痔结扎术后迟发性出血的风险
Risk of late bleeding following hemorrhoidal banding in patients on antithrombotic prophylaxis.
作者信息
Nelson R Scott, Ewing B Mark, Ternent Charles, Shashidharan Maniamparampil, Blatchford Garnet J, Thorson Alan G
机构信息
Colon and Rectal Surgery, Inc, Omaha, NE, USA.
出版信息
Am J Surg. 2008 Dec;196(6):994-9; discussion 999. doi: 10.1016/j.amjsurg.2008.07.036.
BACKGROUND
The risk of bleeding following rubber band ligation of internal hemorrhoids is 1%-2%. This risk may be increased in patients taking antithrombotic therapy. The goal of the current study was to find a safer approach to banding without increasing the risk of bleeding.
METHODS
This retrospective review identified patients undergoing banding while on antithrombotic therapy. These medications were held for 7-10 days following the procedure. The number of bands placed while on antithrombotic therapy and their post band complications were recorded.
RESULTS
There were 605 bands placed on 364 patients taking antithrombotic medications. There were 23 complications involving bleeding, a value that was not statistically different from those not taking antithrombotic therapy. Patients on clopidogrel experienced 50% of the significant bleeding episodes and 18% of the insignificant bleeding episodes.
CONCLUSIONS
Holding antithrombotic medication following banding appears to equalize the risk of bleeding to that of patients not taking antithrombotic medications. Patients taking clopidogrel may be at higher risk for bleeding complications.
背景
内痔橡皮圈套扎术后出血风险为1%-2%。接受抗血栓治疗的患者此风险可能会增加。本研究的目的是找到一种更安全的套扎方法，同时不增加出血风险。
方法
这项回顾性研究纳入了正在接受抗血栓治疗时接受套扎的患者。这些药物在术后停用7-10天。记录接受抗血栓治疗时放置的橡皮圈数量及其套扎后并发症。
结果
对364例接受抗血栓药物治疗的患者放置了605个橡皮圈。有23例并发症涉及出血，该数值与未接受抗血栓治疗的患者相比无统计学差异。服用氯吡格雷的患者发生了50%的严重出血事件和18%的轻微出血事件。
结论
套扎后停用抗血栓药物似乎使出血风险与未服用抗血栓药物的患者相当。服用氯吡格雷的患者发生出血并发症的风险可能更高。
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