Endres Stephen, Hefti Karlee, Schlimgen Erika, Bogduk Nikolai
Pain Clinic of Northwestern Wisconsin, Eau Claire, Wisconsin, USA.
Faculty of Medicine and Health Sciences, The University of Newcastle, New South Wales, Australia.
Pain Med. 2020 May 1;21(5):918-921. doi: 10.1093/pm/pnz354.
To determine prevalence rates of hemorrhagic complications in patients who either ceased or continued anticoagulants during interventional pain procedures.
A total of 1,936 consecutive patients were prospectively monitored during a total of 12,723 injection procedures. The prevalence of hemorrhagic complications was tallied for a variety of procedures performed on patients who ceased or continued various anticoagulants.
No hemorrhagic complications occurred in any patient who continued anticoagulants. Sufficiently large sample sizes were obtained to conclude that, in patients who continued warfarin or clopidrogel during lumbar transforaminal injections and for lumbar facet procedures, the zero prevalence of complications had 95% confidence intervals of 0% to 0.3%. This prevalence was significantly lower than the risk of medical complications in patients who ceased warfarin.
Lumbar transforaminal injections and lumbar facet injections have a very low rate of hemorrhagic complications when patients continue to take anticoagulants.
确定在介入性疼痛治疗过程中停用或继续使用抗凝剂的患者出血并发症的发生率。
在总共12723次注射操作过程中，对1936例连续患者进行前瞻性监测。统计在停用或继续使用各种抗凝剂的患者所进行的各种操作中出血并发症的发生率。
继续使用抗凝剂的患者均未发生出血并发症。获得了足够大的样本量，足以得出结论：在腰椎椎间孔注射和腰椎小关节手术期间继续使用华法林或氯吡格雷的患者中，并发症的零发生率在95%置信区间为0%至0.3%。该发生率显著低于停用华法林患者的医疗并发症风险。
当患者继续服用抗凝剂时，腰椎椎间孔注射和腰椎小关节注射的出血并发症发生率非常低。
