双联抗血小板药物对老年大肠息肉高频电切术后迟发性出血的影响  

The effect of combined use of antiplatelet drugs on late-onset bleeding in elderly patients after high frequency electric resection of the colon polyps on colonoscopy

作　　者：吕龙[1] 黄春[1] 李俊杰[1] 

机构地区：[1]嘉应学院医学院附属医院消化内科,广东省梅州514031

出　　处：《中国医师杂志》2015年第2期239-242,共4页Journal of Chinese Physician

摘　　要：目的 探讨双联抗血小板药物对老年人内镜下行大肠息肉高频电切术后迟发性出血的影响.方法 对2010年1月至2013年12月间本院收治的64例服用抗血小板药物致消化内镜下高频电凝电切大肠息肉术后迟发性出血老年患者的资料进行回顾性分析,将64例服用抗血小板药物患者分为阿司匹林和氯吡格雷单独使用组（单抗组）与两者联合应用组（双抗组）,对两组的临床症状情况、凝血功能时间、出血发生时间、急诊内镜止血需求率、住院止血时间进行比较分析.结果 双抗组的出血发生时间、凝血功能时间、止血时间与单抗组比较差异无统计学意义（P＞0.05）,而双抗组的临床症状严重度、急诊内镜止血需求率与单抗组比较差异有统计学意义（P＜0.01）.结论 双联抗血小板药物比单联抗血小板药物所致内镜下高频电凝电切大肠息肉术后迟发性出血的症状更重,所需内镜下止血的患者更多,应引起临床医师的重视.Objective To explore the effect of combined use of antiplatelet drugs on late-onset bleeding in elderly patients after high frequency electric resection of the colon polyps on colonoscopy.Methods Data with late-onset bleeding after high frequency electric resection of the colon polyps on colonoscopy were collected from 64 elderly patients using antiplatelet drugs from January 2010 to December 2013.Those 64 elderly patiets using antiplatelet drugs were divided into aspirin,clopidogrel,and aspirin ＋ clopidogrel groups.The clinical situation,blood-coagulation time,bleeding-occurrence time,emergency colonoscopy hemostatic rate of demand,and hemostatic time in hospital were analyzed.Results No statistically significant differences were found in the blood-coagulation time,bleeding-occurrence time,and hemostatic time in hospital among aspirin,clopidogrel,and aspirin ＋ clopidogrel groups.However,the clinical situation,and emergency colonoscopy hemostatic rate of demand in aspirin ＋ clopidogrel group were significantly more serious and higher than those of the aspirin or clopidogrel groups （P 〈 0.01）.Conclusions There are more serious clinical situation and higher emergency colonoscopy hemostatic demand in patients with combined use of antiplatelet drugs relative to the use of single antiplatelet drug.The clinicians should pay attention to the combined use of antiplatelet drugs for late-onset bleeding in elderly patients after high frequency electric resection of the colon polyps on colonoscopy.

关 键 词：血小板聚集抑制剂/投药和剂量/副作用 阿司匹林/投药和剂量/副作用 噻氯匹定/投药和剂量/副作用 结肠息肉/外科学/并发症/药物疗法 电外科手术/副作用 出血/化学诱导 

分 类 号：R656[医药卫生—外科学]