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国际消化内镜网络共识:胃肠内镜检查中抗栓药物的管理。

International Digestive Endoscopy Network Consensus on the Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy.

机构信息

Department of Internal Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea.

Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea.

出版信息

Gut Liver. 2024 Sep 15;18(5):764-780. doi: 10.5009/gnl240176. Epub 2024 Sep 3.

Abstract

Antithrombotic agents, including antiplatelet agents and anticoagulants, are widely used in Korea because of the increasing incidence of cardiocerebrovascular disease and the aging population. The management of patients using antithrombotic agents during endoscopic procedures is an important clinical challenge. The clinical practice guidelines for this issue, developed by the Korean Society of Gastrointestinal Endoscopy, were published in 2020. However, new evidence on the use of dual antiplatelet therapy and direct anticoagulant management has emerged, and revised guidelines have been issued in the United States and Europe. Accordingly, the previous guidelines were revised. Cardiologists were part of the group that developed the guideline, and the recommendations went through a consensus-reaching process among international experts. This guideline presents 14 recommendations made based on the Grading of Recommendations, Assessment, Development, and Evaluation methodology and was reviewed by multidisciplinary experts. These guidelines provide useful information that can assist endoscopists in the management of patients receiving antithrombotic agents who require diagnostic and elective therapeutic endoscopy. It will be revised as necessary to cover changes in technology, evidence, or other aspects of clinical practice.

摘要

抗血栓药物,包括抗血小板药物和抗凝剂,在韩国被广泛应用,因为心血管疾病和人口老龄化的发病率不断增加。在进行内镜检查时,管理使用抗血栓药物的患者是一个重要的临床挑战。韩国胃肠内镜学会制定了针对这一问题的临床实践指南,并于 2020 年发布。然而,关于双联抗血小板治疗和直接抗凝管理的新证据已经出现,美国和欧洲已经发布了修订后的指南。因此,对之前的指南进行了修订。心脏病专家是指南制定小组的一部分,建议经过了国际专家的共识达成过程。本指南根据推荐分级、评估、制定和评价方法提出了 14 项建议,并由多学科专家进行了审查。这些指南提供了有用的信息,可以帮助接受抗血栓药物治疗的需要诊断和选择性治疗性内镜检查的患者的内镜医生进行管理。必要时,它将根据技术、证据或临床实践的其他方面的变化进行修订。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1293/11391130/4e88e4ab07cc/gnl-18-5-764-f1.jpg

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