低剂量阿司匹林对腰椎管狭窄手术患者出血的影响

Effects of low-dose aspirin on blood loss of patients with lumbar spinal stenosis surgery

目的观察低剂量阿司匹林对腰椎管狭窄手术患者出血的影响。方法选择择期行单节段后路椎管减压椎间盘摘除植骨融合内固定术患者60例,根据患者术前7 d是否停用低剂量阿司匹林(75 mg·d-1)分为两组,每组30例。对照组患者术前7 d停用阿司匹林,观察组患者服用阿司匹林至术前1 d。两组患者均行后路椎管减压椎间盘摘除植骨融合内固定术,观察并记录患者术中出血量、输血量和手术时间以及术后出血量、输血量。结果观察组和对照组术中出血量分别为(334.1±224.4) m L和(291.5±125.5) m L,组间无显著差异(P> 0.05);术后出血量分别为(188.5±21.2) m L和(135.4±21.9) m L,对照组低于观察组(P <0.05)。两组手术时间无显著差异(P> 0.05),术中、术后均未予输血治疗。结论围术期未停用低剂量阿司匹林不会增加腰椎管狭窄手术患者术中出血量和输血治疗事件,但患者术后出血量增加。

AIM To evaluate the effects of low-dose aspirin on blood loss of patients with lumbar spinal stenosis surgery.METHODS A total of 60 patients scheduled for single segments of posterior spinal canal decompression disceetomy lumbar fusion surgery were selected for the study.According to the anticoagulation scheme,patients were divided into two groups with 30 patients in each.The control group consisted of patients who stopped taking aspirin seven days before the surgery,and the observation group consisted of patients with aspirin (75mg ·d^-1)until the day before surgery.The intraoperative bleeding,postoperative bleeding, operation time and the volume of transfusion were compared between the two groups.RESULTS The blood loss during operation was (334.1 ±224.4)mL in the observation group and (291.5± 125.5)mL in the control group,respectively.There was no significant difference in the blood loss during operation between the two groups (P >0.05).The postoperative blood loss were (188.5±21.2)mL in the observation group and was higher than that in the control group ((135.4±21.9)mL,P <0.05).There was no significant difference in the operation time between the two groups (P >0.05).None of the patients had blood transfusion in the two groups. CONCLUSION Perioperative continuous use of low-dose aspirin does not increase intraoperative bleeding or the need for blood transfusion,but increases postoperative bleeding in the lumbar spinal stenosis surgery.