腹部外科围手术期阿司匹林应用的安全性初探

Safety of perioperative antiplatelet therapy by aspirin in abdominal surgery

目的评价腹部外科围手术期应用阿司匹林的安全性和其对预防血栓事件的作用。方法纳入36例需长期服用阿司匹林的缺血性心脏病或缺血性脑血管病患者,分为试验组和对照组,每组18例。试验组围手术期继续服用阿司匹林,对照组在术前5 d停用阿司匹林,术后5 d重新服用。术后随访30 d,比较两组间出血、心脑血管发生等情况。结果试验组未发生心脑血管事件;对照组术后2例发生心绞痛,1例发生短暂性脑缺血。两组间出血相关并发症及术中出血量[(80±15)mL vs.(68±15)mL,P>0.05]比较,差异无统计学意义。结论围手术期继续使用阿司匹林可以减少心脑血管事件发生,不引起严重出血。

Objective To assess the safety of perioperative antiplatelet therapy by aspirin in elective general abdominal surgery. Methods Thirty-six patients with ischemic heart disease （IHD） or ischemic cerebrovascular disease （ICD） were enrolled and randomly divided into two groups （18 in each）. Aspirin was continued used in treatment group during the perioperative period, while patients in control group stopped using asprin from 5 days before surgery to 5 days after surgery. At 30-day follow-up after surgery, the effect of aspirin on cardiovascular, cerebrovascular and bleeding complications were compared. Results In control group, 2 patients had angina and 1 had transient ischemic attack. No IHD or ICD happened in treatment group. No significant differences in bleeding complications and volume of blood （180±15）mL vs. （68±15）mL,P〉0.051 during operation were seen between the two groups. Conclusions Continue using aspirin during the perioperative period may be relatively safe and can decrease the incidence of II-ID, ICD and dose not induce severe bleeding complications.