接受慢性华法林治疗的患者行开放性腹股沟疝修补术的安全性。

The safety of open inguinal herniorraphy in patients on chronic warfarin therapy.

作者信息

McLemore Elisabeth C, Harold Kristi L, Cha Stephen S, Johnson Daniel J, Fowl Richard J

机构信息

Department of Surgery, Mayo Clinic Arizona, 13400 E Shea Blvd, Scottsdale, AZ 85259, USA.

出版信息

Am J Surg. 2006 Dec;192(6):860-4. doi: 10.1016/j.amjsurg.2006.08.058.

DOI:10.1016/j.amjsurg.2006.08.058

PMID:17161108

Abstract

BACKGROUND

The perioperative management of warfarin therapy increases the complexity of open inguinal herniorraphy.

METHODS

One thousand consecutive patients undergoing open inguinal herniorraphy were retrospectively reviewed. Patients on warfarin therapy were categorized into 3 groups: continued warfarin (CW), discontinued warfarin (DW), and discontinued warfarin with anticoagulation bridge (DWB).

RESULTS

Eighty-eight patients were on chronic warfarin therapy. Warfarin was continued in 19 patients, discontinued in 54, and discontinued with bridge in 15 patients. Operative times were similar between the 3 groups. Length of stay was longest in the discontinued warfarin with bridge group (CW 0.74, DW 0.54, and DWB 3.33 days; P < .0001). There was no significant difference in postoperative complications. The incidence of surgical site hematoma was higher in the continued warfarin and discontinued warfarin with bridge groups (CW 11%, DW 2%, and DWB 13%; P = .14).

CONCLUSIONS

Continuation of warfarin may be a safe alternative to discontinuation of warfarin therapy in select patients undergoing open inguinal herniorraphy.

摘要

背景

华法林治疗的围手术期管理增加了开放性腹股沟疝修补术的复杂性。

方法

回顾性分析连续1000例行开放性腹股沟疝修补术的患者。接受华法林治疗的患者分为3组：继续使用华法林（CW）组、停用华法林（DW）组和停用华法林并采用抗凝桥接（DWB）组。

结果

88例患者接受长期华法林治疗。19例患者继续使用华法林，54例停用华法林，15例停用华法林并采用桥接治疗。3组患者的手术时间相似。住院时间在停用华法林并采用桥接治疗组最长（CW组0.74天，DW组0.54天，DWB组3.33天；P <.0001）。术后并发症无显著差异。继续使用华法林组和停用华法林并采用桥接治疗组的手术部位血肿发生率较高（CW组11%，DW组2%，DWB组13%；P = 0.14）。