妇科单孔腹腔镜围手术期持续服用阿司匹林的价值

Value of continuous use of Aspirin during perioperative period of gynecological single hole laparoscopic surgery

目的探讨妇科单孔腹腔镜围手术期持续服用阿司匹林的价值。方法选择2019年5月至2021年5月景德镇市第二人民医院收治的100例因妇科良性疾病行单孔腹腔镜手术患者,按随机数字表法将患者分为A组和B组,每组各50例。A组持续服用阿司匹林,晨起口服,100 mg/次,每天服用1次;B组在术前5~7 d停用阿司匹林,在术后3 d恢复阿司匹林,晨起口服,100 mg/次,每天服用1次。两组均随访至术后30 d。比较分析两组围手术期的凝血功能、手术情况、心血管不良事件发生情况。结果两组术前1 d、术后1 d的血小板计数(PLT)、凝血酶原时间(PT)、凝血酶时间(TT)、血浆纤维蛋白原(FIB)、凝血反应时间(R)、血液凝固时间(K)比较,差异无统计学意义(P>0.05)。两组的手术时间、术中出血量、术后24 h血红蛋白降低值比较,差异无统计学意义(P>0.05)。随访30 d后,A组的心血管不良事件发生率低于B组,差异有统计学意义(P<0.05)。结论妇科单孔腹腔镜围手术期持续应用阿司匹林能够有效减少心血管不良事件发生,且不会增加患者术中出血风险,能够更好地保证患者安全。

Objective To explore the value of continuous use of Aspirin during perioperative period of gynecological single hole laparoscopy.Methods A total of 100 patients with benign gynecological diseases who underwent single hole laparoscopic surgery in Jingdezhen Second People′s Hospital from July 2019 to July 2021 were selected and divided into group A and group B according to random number table method,with 50 cases in each group.Group A continued to take Aspirin,oral from the morning,100 mg/time,once a day.Group B stopped Aspirin at 5-7 days before operation,resumed Aspirin at 3 days after operation,took it orally in the morning,100 mg/time,once a day.All patients were followed up to 30 days after operation.The perioperative coagulation function,operation condition and the incidence of adverse cardiovascular events in the two groups were compared and analyzed.Results There was no significant difference in the levels of platelet count(PLT),prothrombin time(PT),thrombin time(TT),plasma fibrinogen(FIB),coagulation reaction time(R)and blood coagulation time(K)in the two groups between the first day before operation and the first day after operation(P>0.05).There was no significant difference in the operation time,intraoperative bleeding and 24 h hemoglobin reduction between the two groups(P>0.05).After 30 days of follow-up,the incidence of cardiovascular adverse events in group A was lower than that in group B,the difference was statistically significant(P<0.05).Conclusion The continuous use of Aspirin during the perioperative period of gynecological single hole laparoscopic surgery can effectively reduce the incidence of adverse cardiovascular events,and will not increase the risk of intraoperative bleeding,so as to better ensure the safety of patients.