术前口服阿司匹林对腹腔镜肾肿瘤剜除术术中和术后出血的影响

Effect of preoperative Aspirin on intraoperative and postoperative bleeding in laparoscopic partial nephrectomy

目的研究术前口服阿司匹林对腹腔镜肾肿瘤剜除术术中和术后出血的影响。方法对52例伴慢性心血管疾病的肾肿瘤患者行腹腔镜肾肿瘤剜除术。术前口服阿司匹林患者共31例,其中长期口服小剂量阿司匹林、术前停服不足1周者18例(1组);术前停服阿司匹林超过1周者13例(2组)。从未服用阿司匹林患者21例(3组)。对比三组患者的年龄、肾肿瘤大小、部位、手术时间、术中出血量和术后出血情况及术后并发症的发生率。结果三组的年龄、肾肿瘤大小、部位、手术时间和术中出血量差异无显著性意义(P>0.05),而1组术后引流管拔除时间明显较2、3组延长,术后引流总量也较多。术后输血事件较2、3组发生率高,术后心血管意外发生率3组较1、2组低。结论术前1周内口服阿司匹林不增加腹腔镜肾肿瘤剜除术术中出血量,但能延长术后出血时间,增加术后发生心血管事件的机率。建议腹腔镜肾肿瘤剜除术患者术前停服阿司匹林至少1周以上。

Objective To study the effect of preoperative Aspirin on intraoperative and postoperative bleeding in laparoscopic partial nephrectomy.Methods Fifty-two cases of renal tumor combined with chronic cardiovascular disease which underwent laparoscopic partial nephrectomy were divided into three groups.Group 1 consisted of 18 cases,which had long taken aspirin and stopped taking it for less than a week.Group 2 included 13 cases which stopped taking aspirin for more than a week.Group 3 was composed of 21 cases which had never taken Aspirin.The age of patients,size and site of renal tumor,operating time,intraoperative bleeding,postoperative bleeding and postoperative complications of the three groups were compared.Results The three groups had no significant difference in the age,size and site of renal tumor,operating time and intraoperative bleeding,but the removal time of drainage tube in Group 1 was significantly prolonged than in Group 2 and Group 3,with more fluid drained.The ratio of postoperative blood transfusion was higher in Group 1 than in the other two groups.The postoperative incidence of cardiovascular events in group 3 was lower than that in Group 1 and Group 2.Conclusions Taking oral Aspirin one week before laparoscopic partial nephrectomy does not increase the intraoperative bleeding,but prolongs postoperative bleeding and increases the incidence of cardiovascular events.Therefore,patients should stopped taking aspirin more than 1 week before laparoscopic partial nephrectomy.