中国临床医学2024，Vol.31Issue(3)：361-366,6.DOI:10.12025/j.issn.1008-6358.2024.20240547
肝硬化胃静脉曲张合并门静脉血栓患者内镜下组织胶注射治疗后早期抗凝的出血风险评估
Assessment of bleeding risk for early anticoagulation after endoscopic cyanoacrylate injection in cirrhosis patients with gastric varices and portal vein thrombosis
摘要
Abstract
Objective To explore the effects of anticoagulation treatment to postoperative bleeding events in liver cirrhosis patients with gastric varices and portal vein thrombosis.Methods Patients diagnosed with portal vein thrombosis and treated with endoscopic cyanoacrylate injection at Zhongshan Hospital,Fudan University due to gastric variceal bleeding from January 2023 to December 2023 were included.Clinical data of patients were collected,and patients were divided into anticoagulant group and non-anticoagulant group based on whether anticoagulant treatment was performed within 48 h after treatment.Re-bleeding in patients was evaluated in 6 weeks of follow-up.Cox regression was used for univariate and multivariate analysis of re-bleeding within 6 weeks after treatment.Results A total of 160 patients were included,of whom 65 patients received anticoagulation treatment within 48 h after endoscopic cyanoacrylate injection.There were no statistically significant differences in gender,etiology of liver cirrhosis,dosage of cyanoacrylate and sclerosing agents,and Child-Pugh grading between the two groups.There was no statistically significant difference in re-bleeding rate within 6 weeks after treatment between the two groups(1.54％vs 1.05％,P=0.795).Multivariate Cox regression analysis showed that the large amount of cyanoacrylate was a risk factor for re-bleeding within 6 weeks after endoscopic treatment(HR=5.862,P=0.015).Conclusions For patients with liver cirrhosis,gastric varices,and portal vein thrombosis,who receive endoscopic cyanoacrylate injection,early anticoagulation does not increase the risk of re-bleeding after treatment,while a large amount of cyanoacrylate injection may be a risk factor for re-bleeding.However,sample should be increased to verify.关键词
肝硬化/胃静脉曲张/门静脉血栓/抗凝治疗/内镜下组织胶注射Key words
cirrhosis/gastric varices/portal vein thrombosis/anticoagulation/endoscopic cyanoacrylate injection分类
医药卫生引用本文复制引用
王慧珊,房晔,叶丝陶,李星寰,黄晓铨,王剑,马丽黎,陈世耀..肝硬化胃静脉曲张合并门静脉血栓患者内镜下组织胶注射治疗后早期抗凝的出血风险评估[J].中国临床医学,2024,31(3):361-366,6.基金项目
上海市科学技术委员会项目(21ZR1458000,22Y11907400).Supported by Project of Shanghai Municipal Commission of Science and Technology(21ZR1458000,22Y11907400). （21ZR1458000,22Y11907400）
