抗血小板治疗对经皮肾穿刺造瘘术术后出血风险的影响

Impact of antiplatelet therapy on risk of hemorrhage after percutaneous nephrostomy

目的评价应用抗血小板药物对经皮肾穿刺造瘘术(PCN)术后出血发生风险的影响。方法收集接受CT引导PCN治疗的196例患者(244个肾脏),根据术后PCN出血情况分为出血组和未出血组,分析患者PCN术后出血发生的危险因素。结果 PCN术后23例患者27个(27/244,11.07%)肾脏发生出血。单因素分析显示出血与未出血组除抗血小板药物外,其余因素差异均无统计学意义(P>0.05)。Logistic回归分析显示应用双药抗血小板是发生出血风险的高危因素(OR=12.381,P=0.002)。结论单药阿司匹林抗血小板治疗并未增加PCN术后出血风险,而双药抗血小板治疗PCN出血风险显著增加;正常的凝血功能也是预防术后出血的保证。

Objective To explore the impact of antiplatelet agents on the occurrence of hemorrhage after percutaneous nephrostomy （PCN）.Methods Totally 197 patients （244 kidneys） underwent PCN were enrolled and divided into postoperative hemorrhage group and without postoperative hemorrhage group. The possible factors of the postoperative hemorrhage were analyzed.Results Post-operative hemorrhage occurred in 23 patients with 27 kidneys （27/244, 11.07%）. Univariate analysis showed that except for antiplatelet drugs, the other factors had no statistical difference between the two groups （P〉0.05）. Logistic regression analysis showed that taking dual-antiplatelet was the risk factor of hemorrhage after PCN （OR=12.381, P=0.002）.Conclusion Single aspirin therapy can not increase the risk of hemorrhage after PCN, while taking dual-antiplatelet might increase the risk of hemorrhage. Normal clotting function is also a guarantee of preventing hemorrhage after PCN.