不间断应用抗凝药对胆囊微创手术的影响

Effect of continuous application of anticoagulant drugs in minimally invasive gallbladder surgery

目的探究不间断应用抗凝药对胆囊微创手术的影响。方法选取2011年1月-2015年1月该院收治的80例进行胆囊微创手术的患者为研究对象,采用随机数表法将80例患者分为观察组和对照组,持续给予观察组40例患者阿司匹林,对照组40例患者术前7 d停用阿司匹林。对比两组患者的术中出血量、手术时间、腹腔引流量、中转开腹、术后住院时间、术后再出血、术后输血、术前血红蛋白、术后血红蛋白和血栓栓塞性事件发生情况。结果两组患者的术中出血量、手术时间、腹腔引流量、中转开腹、术后住院时间、术后再出血和术前血红蛋白水平差异不具有统计学意义(P>0.05)。观察组患者的术后输血的患者多于对照组,发生血栓栓塞事件的患者少于对照组,术后观察组患者的血红蛋白水平低于对照组患者,差异具有统计学意义(P<0.05)。结论胆囊微创手术患者不间断使用抗凝药物能够降低血栓栓塞性事件的发生率,但会延长术后出血时间,因此应当合理控制抗凝药物的使用时间。

[ Objective ] To explore the influence continuous application of anticoagulation in minimally invasive gallbladder surgery. [ Methods ] 80 cases taken minimally invasive gallbladder surgery from January 2011 to January 2015 were randomly divided into two groups by number table method. Patients in the observation group given continuous Aspirin while in the control group patients ceased taken seven days preoperatively. Compare the blood loss, operation time, peritoneal drainage, conversion to open surgery, postoperative hospital stay, postoperative hemor- rhage, postoperative blood transfusion, preoperative hemoglobin, postoperative hemoglobin, thromboembolie event occurrence between the two groups. [ Results ] The blood loss, operative time, abdominal drainage, conversion to open surgery, postoperative hospital stay, postoperative bleeding, preoperative hemoglobin level difference have no statisti- cally significance （P 〉 0.05）. postoperative transfusion in the observation group was more than control group, while thromboembolic events and hemoglobin level was less than the control group, the difference was statistically significant （P 〈 0.05）. [ Conclusions ] Continuous application of anticoagulation in minimally invasive gallbladder surgery can reduce the incidence of thromboembolic events, but will prolong bleeding time and the use of anticoagulants time should be reasonable.