抗栓治疗停药后患者结肠镜息肉切除术后出血的风险。
Risk of colonoscopic post-polypectomy bleeding in patients after the discontinuation of antithrombotic therapy.
机构信息
Department of Endoscopy, Saku Central Hospital Advanced Care Center, Saku, Japan; Department of Gastroenterology, Nara City Hospital, Nara, Japan.
Department of Endoscopy, Saku Central Hospital Advanced Care Center, Saku, Japan.
出版信息
Turk J Gastroenterol. 2020 Nov;31(11):752-759. doi: 10.5152/tjg.2020.19428.
BACKGROUND/AIMS: Few studies have examined the incidence of post-polypectomy bleeding (PPB) after discontinuation of antithrombotic therapies. Therefore, this study aimed to evaluate the incidence of PPB and thromboembolic events in patients whose antithrombotic agents were discontinued before colonoscopy.
MATERIALS AND METHODS
We retrospectively selected all patients who underwent colon polypectomy at a community hospital. A total of 282 patients (540 polypectomies) discontinued antithrombotic agents (group 1), and 1,648 patients (2,827 polypectomies) did not take antithrombotic agents (group 2). The cessation periods before and after polypectomies were 4 and 3 days for warfarin, 5 and 3 days for anti-platelet agents, and 7 and 5 days of combination therapy, respectively. Main outcome measurements were the incidence of PPB and thromboembolic events.
RESULTS
Immediate PPB rates were 3.9% (11/282) in group 1 and 4.6% (76/1648) in group 2 (adjusted odds ratio [OR], 0.85; 95% confidence interval [CI], 0.42-1.72; p=0.65). Delayed PPB rates were 1.4% (4/282) in group 1 and 1.1% (18/1648) in group 2 (adjusted OR, 1.24; 95% CI, 0.36-4.24; p=0.732). No thromboembolic events were observed in either group.
CONCLUSION
Our cessation periods were appropriate, and further shortening of these periods is possible.
背景/目的：鲜有研究探讨停用抗栓治疗后息肉切除术后出血（PPB）的发生率。因此，本研究旨在评估停用抗栓药物的患者在结肠镜检查前的 PPB 发生率和血栓栓塞事件。
材料和方法
我们回顾性选择了在社区医院行结肠息肉切除术的所有患者。共有 282 例患者（540 例息肉切除术）停用抗栓药物（第 1 组），1648 例患者（2827 例息肉切除术）未服用抗栓药物（第 2 组）。华法林前后的停药期为 4 天和 3 天，抗血小板药物为 5 天和 3 天，联合治疗为 7 天和 5 天。主要观察指标是 PPB 和血栓栓塞事件的发生率。
结果
第 1 组的即刻性 PPB 发生率为 3.9%（11/282），第 2 组为 4.6%（76/1648）（调整后的优势比[OR]，0.85；95%置信区间[CI]，0.42-1.72；p=0.65）。第 1 组延迟性 PPB 发生率为 1.4%（4/282），第 2 组为 1.1%（18/1648）（调整后的 OR，1.24；95% CI，0.36-4.24；p=0.732）。两组均未发生血栓栓塞事件。
结论
我们的停药期是适当的，进一步缩短这些停药期是可行的。
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