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世界核心医学期刊文摘（胃肠病学分册） 2006年第10期2卷 27-27页

作者： Giles E. Walton-Salih E. Shah N. Hinds R. 孟欣颖 Department of Child Health King's College HospitalDenmark HillLondon SE5 9RSUnited Kingdom

Background and Study Aims: Routine coagulation screening prior to gastrointestinal endoscopy is performed in many centres in the UK, despite the lack of any evidence to support the practice. The aim of this study was to assess the benefits of routine pre-endoscopy coagulation screening in children and to assess how widespread this practice is in the UK. Patients and Methods: We performed a retrospective analysis of the case notes of 250 consecutive patients who had undergone routine coagulation screening prior to endoscopy and biopsy, in accordance with our unit’s protocol, looking for evidence of abnormal results or episodes of bleeding. We also performed a telephone survey of the protocols for coagulation screening at other paediatric units in the UK which are known to perform gastro-intestinal endoscopy on a routine basis. Results: According to our hospital’s laboratory reference ranges, 16.8%of the children who underwent endoscopy and biopsy had abnormal clotting. This was neither clinically significant nor associated with an increased bleeding risk in any patient. Of the 23 UK paediatric gastroenterology centres surveyed, including our own, five (21.7%) perform routine coagulation screening before endoscopy. Conclusions: This study suggests that, although it is a relatively common practice, routine coagulation screening is not indicated in children who are undergoing gastrointestinal endoscopy and biopsy, and that it does not predict those at risk of significant bleeding. We would therefore suggest that if pre-endoscopy screening is to be performed, it should be reserved for those who are potentially at high risk of bleeding.

关键词：胃肠镜检查凝血功能参考值内镜检查胃肠病病例记录医院实验室电话调查出血事件

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利伐沙班Ⅲ期研究优势明显

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吉林医学信息 2010年第Z1期27卷 2-2页

今年拜耳宣布了利伐沙班关键性双盲Ⅲ期ROCKET AF试验的结果,结果显示,利伐沙班在降低心房颤动患者(AF)发生卒中和非中枢神经系统栓塞的效果优于华法林,其明显降低了医生和患者最为关注的出血事件发生率,

关键词：心房颤动患者中枢神经系统出血事件抗凝标准研究优势双盲研究依诺肝素口服抗凝药生物利用度

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经皮冠状动脉介入术后的临床终点定义及其与晚期死亡率的关系:一项归因风险评估

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世界核心医学期刊文摘（心脏病学分册） 2006年第11期2卷 46-46页

作者： Chew D.P. Bhatt D.L. Lincoff A.M. 杜媛 Flinders Medical Centre Flinders Drive Bedford Park SA 5042 Australia Prof.

Objectives: To explore the relative and absolute risks associated with various definitions for myocardial infarction, bleeding and revascularisation within the context of percutaneous coronary intervention(PCI). Methods: The REPLACE-2(randomised evaluation of PCI linking Angiomax to reduced clinical events) database of patients undergoing PCI was used. Various definitions of myocardial infarction, bleeding and revascularisation were modelled by logistic regression assessing their relationship with 12-month mortality. Estimates from these models were used to calculate the “attributable fraction”for late mortality associated with each definition. Results: The most liberal definition of myocardial infarction was associated with an attributable risk of 13.7%(95%CI 3.4%to 23.0%). The most stringent definition was associated with an attributable risk of 4.6%(95%CI 0.6%to 8.6%). Restrictive definitions of bleeding such as TIMI(thrombolysis in myocardial infarction) major bleeding are associated with a high odds ratio of risk(6.1, 95%CI 2.1 to 17.7, p=0.001) but low attributable fraction(3.5%, 95%CI 0.9%to 6.8%). Conclusions: Stringent end point definitions may under-represent the clinical significance of adverse outcomes after PCI. Considering both the proportional and absolute risk associated with definitions may be a more useful method for evaluating clinical trial end points. This analysis supports the current definitions of ischaemic events but suggests that more liberal definitions of bleeding events may also be relevant to late mortality.

关键词：临床终点比伐卢定风险评估血运重建相对和绝对临床事件评估研究晚期死亡出血事件比值比

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肝硬化患者服用直接口服抗凝剂与传统抗凝剂的疗效与安全性比较

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临床肝胆病杂志 2017年第7期33卷 1283-1283页

作者：暴文春祁兴顺李宏宇沈阳军区总医院消化内科

【据《Eur J Haematol》2016年12月报道】题：比较肝硬化患者服用直接口服抗凝药与传统抗凝剂的疗效与安全性（作者Hum J等）肝硬化患者中,凝血障碍复杂,存在出血和血栓风险。尚无研究证实肝硬化患者服用直接口服抗凝剂的疗效与安全性... 详细信息

【据《Eur J Haematol》2016年12月报道】题：比较肝硬化患者服用直接口服抗凝药与传统抗凝剂的疗效与安全性（作者Hum J等）肝硬化患者中,凝血障碍复杂,存在出血和血栓风险。尚无研究证实肝硬化患者服用直接口服抗凝剂的疗效与安全性是否优于维生素K拮抗剂。来自美国的Hum等进行的回顾性队列研究旨在比较肝硬化患者服用两类药物的结局。

关键词：抗凝剂口服抗凝药拮抗剂凝血障碍回顾性队列研究观察终点出血事件低分子肝素率更

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