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目的探讨急性冠脉综合征(ACS)双联抗血小板治疗合并上消化道出血的临床特点及防治措施。方法选择我院2009年1月—2012年4月住院的因双联抗血小板合并致急性上消化道出血的29例,对其临床表现、治疗过程、危险因素进行回顾性分析。结果 ACS患者双联抗血小板治疗出血以老年人多见,多表现为排棕色或柏油样便,症状不典型。经停用抗血小板药、抗凝药,加用PPI治疗,结合输血等治疗,治愈27例,死亡2例。结论 ACS双联抗血小板治疗时应充分评估消化道出血风险,并合理进行预防。
Objective To investigate the clinical characteristics and prevention and treatment of acute coronary syndrome (ACS) double antiplatelet therapy combined with upper gastrointestinal bleeding. Methods A total of 29 hospitalized patients with acute upper gastrointestinal bleeding who were hospitalized in our hospital from January 2009 to April 2012 were retrospectively analyzed for their clinical manifestations, course of treatment and risk factors. Results In patients with ACS, dual antiplatelet hemorrhage was more common in the elderly than in those with brown or tarry stools. The symptoms were not typical. After the withdrawal of antiplatelet drugs, anticoagulants, plus PPI treatment, combined with transfusion and other treatment, cured 27 cases, 2 patients died. Conclusion ACS double antiplatelet therapy should fully assess the risk of gastrointestinal bleeding and reasonable prevention.