双联抗血小板治疗患者的胆胰内镜及外科手术：一项单中心研究
Biliary-Pancreatic Endoscopic and Surgical Procedures in Patients under Dual Antiplatelet Therapy: A Single-Center Study.
作者信息
Abdel Samie Ahmed, Stumpf Michael, Sun Rui, Theilmann Lorenz
机构信息
Department of Gastroenterology, Pforzheim Hospital, Pforzheim, Germany.
出版信息
Clin Endosc. 2013 Jul;46(4):395-8. doi: 10.5946/ce.2013.46.4.395. Epub 2013 Jul 31.
Abstract
BACKGROUND/AIMS: Dual antiplatelet therapy has to be used for at least 1 month after placement of bare metal coronary stents and for a minimum of 1 year after placement of drug eluting stents. Because of the higher risk of bleeding, guidelines strongly recommend to delay elective surgery until dual antiplatelet therapy is ended. However, no data are available regarding the bleeding risk in patients on combined aspirin/clopidogrel therapy undergoing surgical or high-risk endoscopic procedures.
METHODS
We retrospectively analyzed the medical reports of patients on dual antiplatelet therapy, the patients who had to undergo emergency biliary-pancreatic surgery or endoscopic retrograde cholangiography with endoscopic sphincterotomy while in our unit between January 2009 and July 2012.
RESULTS
In our series, biliary-pancreatic surgical and endoscopic procedures were safely performed in 11 consecutive patients on dual antiplatelet therapy with no evidence of bleeding.
CONCLUSIONS
In emergency, surgical and high risk endoscopic procedures may be performed in patients on dual antiplatelet therapy.
摘要
背景/目的：裸金属冠状动脉支架置入后双联抗血小板治疗必须至少使用1个月，药物洗脱支架置入后至少使用1年。由于出血风险较高，指南强烈建议在双联抗血小板治疗结束前推迟择期手术。然而，关于接受联合阿司匹林/氯吡格雷治疗的患者在进行外科手术或高风险内镜检查时的出血风险，尚无相关数据。
方法
我们回顾性分析了2009年1月至2012年7月期间在我院接受双联抗血小板治疗、必须接受急诊胆胰手术或内镜逆行胰胆管造影术并进行内镜括约肌切开术的患者的病历报告。
结果
在我们的系列研究中，11例接受双联抗血小板治疗的患者安全地进行了胆胰外科手术和内镜检查，没有出血迹象。
结论
在紧急情况下，接受双联抗血小板治疗的患者可以进行外科手术和高风险内镜检查。
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