围手术期持续服用阿司匹林对老年腹腔镜手术患者出血量及护理分析

Effect of Continuously Taking Aspirin in Perioperative Period on Blood Loss of Elderly Patients Undergoing Laparoscopic Operation and Related Nursing Measures

目的 围手术期持续服用阿司匹林对老年腹腔镜手术患者出血量的影响及相关护理分析.方法 选取我院2013年5月至2016年5月86例老年腹腔镜手术患者为研究对象,采用随机数表法将纳入患者分为持续组(n=43)与停用组(n=43).持续组在腹腔镜手术围手术期不停用阿司匹林,停用组在术前5d停用阿司匹林,术后5d再行服用.比较两组术中与术后情况、凝血指标、并发症发生率.结果 持续组手术时间、术中出血量、术后引流量、住院时间与停用组比较差异无统计学意义(P>0.05).持续组术后5d的凝血酶原时间(PT)、活化部分凝血活酶时间(aP TT)显著高于停用组(P<0.05),纤维蛋白原(Fbg)显著低于停用组(P<0.05).持续组的出血、胃肠道不适发生率分别为2.3%、4.7%与停用组的0.0%、2.3%比较差异无统计学意义(P>0.05);持续组下肢深静脉血栓发生率为2.3%显著低于停用组的9.3%(P<0.05).结论 围手术期不停用阿司匹林不会显著增加术后出血风险,同时可以降低下肢深静脉血栓发生率.

Objective To study the effect of continuously taking aspirin in perioperative period on blood loss of elderly patients undergoing laparoscopic operation and related nursing measures.Methods From May 2013 to May 2016,86 elderly patients undergoing laparoscopic operation in our hospital were randomly divided into the continuous group(n=43)and the withdrawal group(n=43)by the random number table method.The continuous group continued to take aspirin during the perioperative period of laparoscopic operation while the withdrawal group stopped to take aspirin at 5 days before operation,and continued to take aspirin at 5 days after operation.The intraoperative and postoperative situation,coagulation indexes and incidence rate of complications were compared between the two groups.Results There was no significant difference in operation time,intraoperative blood loss,postoperative drainage volume and hospitalization time between the continuous group and the withdrawal group(P>0.05).The prothrombin time(PT)and activated partial thromboplastin time(aPTT)of the continuous group at 5 days after operation were significantly longer than those of the withdrawal group(P<0.05),and the fibrinogen(Fbg)level was significantly lower than that in the withdrawal group(P<0.05).There was no significant difference between the continuous group and the withdrawal group in the incidence rates of bleeding and gastrointestinal discomfort(P>0.05).The incidence ra deep venous thrombosis of lower limbs in the continuous group(2.3%)significantly lower than those in the withdrawal group(9.3%)(P<0.05).Conclusion.Use of aspirin during perioperative period will not increase the risk of bleeding after operation.Meanwhile,it can reduce the incidence of pulmonary embolism and deep venous thrombosis.