Department of Orthopaedic Surgery, Park Nicollet Health Services, St. Louis Park, Minnesota, USA.
J Arthroplasty. 2009 Sep;24(6 Suppl):77-83. doi: 10.1016/j.arth.2009.06.002. Epub 2009 Jul 22.
The use of aspirin for venous thromboembolism (VTE) prophylaxis after major orthopaedic surgery is controversial. The hypothesis of the present study is that aspirin will decrease the rate of operative site bleeding without increasing thromboembolic events when aspirin is used for VTE prophylaxis after major orthopaedic surgery. A pooled analysis of 14 randomized controlled trials (RCTs) cited by the American College of Chest Physicians (ACCP) guidelines was performed to determine pooled rates of symptomatic deep vein thromboses, pulmonary emboli (PE), fatal PE, and operative site bleeding rates. The VTE rates with aspirin were not significantly different than the rates for vitamin K antagonists (VKA), low molecular weight heparins (LMWH), and pentasaccharides. The operative site bleeding relative risks of VKA, LMWH, and pentasaccharides versus aspirin, are 4.9, 6.4, and 4.2, respectively. A pooled analysis of RCTs supports the use of aspirin for VTE prophylaxis after major orthopaedic surgery.
在大型骨科手术后，使用阿司匹林预防静脉血栓栓塞症（VTE）存在争议。本研究的假设是，在大型骨科手术后使用阿司匹林预防 VTE 时，阿司匹林将降低手术部位出血的发生率，而不会增加血栓栓塞事件的发生。对美国胸科医师学院（ACCP）指南中引用的 14 项随机对照试验（RCT）进行了荟萃分析，以确定有症状的深静脉血栓形成、肺栓塞（PE）、致命性 PE 和手术部位出血率的汇总发生率。阿司匹林的 VTE 发生率与维生素 K 拮抗剂（VKA）、低分子肝素（LMWH）和戊聚糖的发生率没有显著差异。VKA、LMWH 和戊聚糖相对于阿司匹林的手术部位出血相对风险分别为 4.9、6.4 和 4.2。RCT 的荟萃分析支持在大型骨科手术后使用阿司匹林预防 VTE。
