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接受抗血栓治疗的肺结节患者经皮活检和微波消融的安全性和有效性:一项利伐沙班桥接治疗的研究

Safety and efficacy of percutaneous biopsy and microwave ablation in patients with pulmonary nodules on antithrombotic therapy: A study with rivaroxaban bridging.

作者信息

Wang Nan, Xue Tianyu, Zheng Wenwen, Shao Zhongying, Liu Zhuang, Dai Faliang, Xie Qi, Sang Jing, Ye Xin

机构信息

Department of Oncology, Shandong Provincial Qianfoshan Hospital, Shandong University of Traditional Chinese Medicine, Jinan, People's Republic of China.

Department of Oncology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Lung Cancer Institute, Jinan, People's Republic of China.

出版信息

Thorac Cancer. 2024 Oct;15(28):1989-1999. doi: 10.1111/1759-7714.15425. Epub 2024 Aug 18.

Abstract

BACKGROUND

To evaluate the safety and efficacy of percutaneous biopsy and microwave ablation (B + MWA) in patients with pulmonary nodules (PNs) who are receiving antithrombotic therapy by rivaroxaban as bridging therapy.

METHODS

The study comprised 187 patients with PNs who underwent 187 B + MWA sessions from January 1, 2020, to December 31, 2021. The enrolled patients were divided into two groups: Group A, who received antithrombotic therapy five days before the procedure and received rivaroxaban as a bridging drug during hospitalization, and group B, who had no antithrombotic treatment. Information about the technical success rate, positive biopsy rate, complete ablative rate, and major complications were collected and analyzed.

RESULTS

Group A comprised 53 patients and group B comprised 134 patients. The technical success rate was 100% in both groups. The positive biopsy rates were 88.68% and 91.04%, respectively (p = 0.6211, X = 0.2443). In groups A and B, the complete ablative rates at 6, 12, and 24 months were 100.0% versus 99.25%, 96.23% versus 96.27%, and 88.68% versus 89.55%, respectively. There were no significant differences in bleeding and thrombotic complications between the two groups. No grade 5 complications occurred.

CONCLUSIONS

It is generally considered safe and effective that patients who are on antithrombotic therapy by rivaroxaban as bridging to undergo B + MWA for treating PNs.

摘要

背景

评估在接受利伐沙班作为桥接治疗的抗血栓治疗的肺结节(PN)患者中,经皮活检和微波消融(B + MWA)的安全性和有效性。

方法

本研究纳入了2020年1月1日至2021年12月31日期间接受187次B + MWA治疗的187例PN患者。将入选患者分为两组:A组,在手术前5天接受抗血栓治疗,并在住院期间接受利伐沙班作为桥接药物;B组,未接受抗血栓治疗。收集并分析有关技术成功率、活检阳性率、完全消融率和主要并发症的信息。

结果

A组53例患者,B组134例患者。两组的技术成功率均为100%。活检阳性率分别为88.68%和91.04%(p = 0.6211,X = 0.2443)。在A组和B组中,6个月、12个月和24个月时的完全消融率分别为100.0%对99.25%、96.23%对96.27%、88.68%对89.55%。两组在出血和血栓形成并发症方面无显著差异。未发生5级并发症。

结论

对于接受利伐沙班作为桥接抗血栓治疗的患者,采用B + MWA治疗PN通常被认为是安全有效的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9456/11444927/7aef9ab89d00/TCA-15-1989-g004.jpg

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