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[接受血小板聚集抑制剂治疗患者的胸膜腔操作:一项意见调查]

[Pleural procedures in patients treated by platelet aggregation inhibitors: An opinion survey].

作者信息

Dangers L, Similowski T, Chenivesse C

机构信息

Service de pneumologie et de réanimation médicale, groupe hospitalier Pitié-Salpêtrière - Charles-Foix, Assistance publique-Hôpitaux de Paris, 75013 Paris, France.

Service de pneumologie et de réanimation médicale, groupe hospitalier Pitié-Salpêtrière - Charles-Foix, Assistance publique-Hôpitaux de Paris, 75013 Paris, France.

出版信息

Rev Mal Respir. 2016 Jan;33(1):41-6. doi: 10.1016/j.rmr.2015.06.006. Epub 2015 Jul 14.

Abstract

BACKGROUND

When pleural procedures (thoracocentesis, blind pleural biopsies and chest tube insertion) are required in patients taking long-term platelet aggregation inhibitors, the risk of bleeding must be balanced against the risk of arterial thrombosis. Currently, the bleeding risk of pleural procedures is poorly understood.

OBJECTIVE

The objective of the survey was to gather the opinion of respiratory physicians regarding the bleeding risk of pleural procedures in patients taking platelet aggregation inhibitors.

METHODS

We emailed a standardized questionnaire designed by the French National Authority for Health to 2697 French respiratory physicians.

RESULTS

One hundred and eighty-eight of the 2697 questionnaires were returned (response rate: 7 %). The respiratory physicians declared that they performed an average of 8 pleural procedures per month. One hundred and seventy-five responders (95 %) practised pleural procedures in patients receiving platelet aggregation inhibitors; 68 of them (39 %) reported experiencing haemorrhagic complications. The bleeding risk associated with thoracentesis and chest tube insertion was considered minor by 97.8 and 65 % of responders respectively, whereas it was considered major for blind pleural biopsies by 73.4 %. Respiratory physicians were more reticent about performing pleural procedures in patients treated with clopidogrel than in those taking aspirin.

CONCLUSION

This study provides an overview of how respiratory physicians perceive the bleeding risk associated with pleural procedures in patients taking platelet aggregation inhibitors.

摘要

背景

对于长期服用血小板聚集抑制剂的患者,在需要进行胸膜操作(胸腔穿刺术、盲法胸膜活检和胸腔置管)时,必须在出血风险与动脉血栓形成风险之间进行权衡。目前,人们对胸膜操作的出血风险了解甚少。

目的

本次调查的目的是收集呼吸内科医生对于服用血小板聚集抑制剂的患者进行胸膜操作时出血风险的看法。

方法

我们将法国国家卫生管理局设计的一份标准化问卷通过电子邮件发送给2697名法国呼吸内科医生。

结果

2697份问卷中有188份被退回(回复率:7%)。呼吸内科医生宣称他们每月平均进行8次胸膜操作。175名回复者(95%)对接受血小板聚集抑制剂治疗的患者实施胸膜操作;其中68人(39%)报告曾出现出血并发症。分别有97.8%和65%的回复者认为胸腔穿刺术和胸腔置管相关的出血风险较小,而73.4%的回复者认为盲法胸膜活检的出血风险较大。与服用阿司匹林的患者相比,呼吸内科医生在为服用氯吡格雷的患者进行胸膜操作时更加谨慎。

结论

本研究概述了呼吸内科医生如何看待服用血小板聚集抑制剂的患者进行胸膜操作时的出血风险。

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