腕管综合征手术治疗中围手术期使用口服抗凝药物。一项初步研究。
The perioperative use of oral anticoagulants during surgical procedures for carpal tunnel syndrome. A preliminary study.
机构信息
Department of Neurosurgery, Radboud University Nijmegen Medical Center, Reinier Postlaan 4, 6500HB, Nijmegen, The Netherlands.
出版信息
Acta Neurochir (Wien). 2010 Jul;152(7):1211-3. doi: 10.1007/s00701-010-0603-z. Epub 2010 Feb 7.
BACKGROUND
To evaluate the feasibility of designing a randomized controlled study whether open carpal tunnel release (OCTR) surgery can be performed safely under systemic anticoagulant therapy using acetylsalicylacid (ASA) or acenocoumarol (ACM), this preliminary, observational study was performed.
METHODS
Prospectively, during 1 year, data were collected from all patients who underwent conventional OCTR at the neurosurgical department of the Canisius Wilhelmina Hospital, Nijmegen, The Netherlands. Patients continued anticoagulant treatment perioperatively.
RESULTS
A total of 364 patients were operated on, of whom 45 continued ASA and seven ACM treatment. Only one patient using ASA complained of a postoperative subcutaneous hemorrhage. In the control group without anticoagulants, none of the patients had a bleeding postoperatively.
CONCLUSION
Continuation of anticoagulant treatment is safe for OCTR. The adverse effects of stopping treatment for surgery can be severe. As a result of this study, we have changed our surgery protocol for OCTR and continue anticoagulant treatment perioperatively.
背景
为评估设计一项随机对照研究的可行性，即在使用乙酰水杨酸（ASA）或醋硝香豆素（ACM）的全身抗凝治疗下，开放性腕管松解术（OCTR）是否可以安全进行，进行了这项初步观察性研究。
方法
前瞻性地，在 1 年期间，从荷兰奈梅亨坎尼斯威灵顿医院神经外科接受常规 OCTR 的所有患者中收集数据。患者在围手术期继续接受抗凝治疗。
结果
共有 364 名患者接受了手术，其中 45 名继续使用 ASA，7 名使用 ACM。仅 1 名使用 ASA 的患者抱怨术后皮下出血。在没有抗凝剂的对照组中，没有患者术后发生出血。
结论
继续抗凝治疗对 OCTR 是安全的。停止手术治疗的不良反应可能很严重。由于这项研究，我们已经改变了 OCTR 的手术方案，并在围手术期继续抗凝治疗。
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