阿司匹林对1或2节段腰椎融合手术的抗血栓形成作用：术前7天之前和之后停用阿司匹林的两组之间的比较。
Antithrombotic effects of aspirin on 1- or 2-level lumbar spinal fusion surgery: a comparison between 2 groups discontinuing aspirin use before and after 7 days prior to surgery.
作者信息
Park Jin Hoon, Ahn Yongchel, Choi Byeong Sam, Choi Kyu-Taek, Lee Kyuhwak, Kim Se Hun, Roh Sung Woo
机构信息
Department of Neurological Surgery, University of Ulsan College of Medicine, Gangneung, Korea.
出版信息
Spine (Phila Pa 1976). 2013 Aug 15;38(18):1561-5. doi: 10.1097/BRS.0b013e31829a84d2.
STUDY DESIGN
Retrospective clinical analysis.
OBJECTIVE
To study proper discontinuation date of aspirin in spinal fusion surgery.
SUMMARY OF BACKGROUND DATA
It is thought that excess bleeding can be normalized if aspirin intake is discontinued approximately 7 days before surgery; however, the average life span of a platelet is generally regarded to be 7 to 10 days.
METHODS
From January 2004 to December 2009, a single surgeon performed 182 cases of 1- or 2-level lumbar fusion surgical procedures. Patients who were aspirin users (n = 86) were divided into 2 groups according to the number of days prior to surgery that they discontinued their aspirin use: the aspirin 1 group discontinued their aspirin use 3 to 7 days before surgery and the aspirin 2 group discontinued their aspirin use 7 to 10 days before surgery. Ninety-six patients who did not use aspirin before surgery were selected for the control group. We retrospectively compared the several hematological parameters among the 2 aspirin groups and the control group.
RESULTS
Both the total amount of drained blood and the duration of indwelling of the drainage catheter were significantly less in the control group than in the aspirin 1 group in patients who underwent either type of 1-level fusion surgery. However, those were not significantly different between aspirin 2 group and control group in patients who underwent either type of 1-level fusion surgery. Only drainage catheter was significantly less in the control group than in the aspirin 1 group in patients who underwent 2-level fusion surgery.
CONCLUSION
Only the aspirin 1 group, wherein patients discontinued aspirin use 3 to 7 days before surgery, showed a greater drained blood and drainage catheter than the control group. If aspirin was discontinued 7 days or longer before surgery, there was no difference in the study parameters, compared with the control group.
LEVEL OF EVIDENCE
研究设计
回顾性临床分析。
目的
研究脊柱融合手术中阿司匹林的合适停药日期。
背景资料总结
一般认为，如果在手术前约7天停止服用阿司匹林，过量出血情况可恢复正常；然而，血小板的平均寿命通常被认为是7至10天。
方法
2004年1月至2009年12月，由一名外科医生实施了182例1或2节段腰椎融合手术。服用阿司匹林的患者（n = 86）根据术前停用阿司匹林的天数分为2组：阿司匹林1组在术前3至7天停用阿司匹林，阿司匹林2组在术前7至10天停用阿司匹林。选取96例术前未服用阿司匹林的患者作为对照组。我们回顾性比较了2个阿司匹林组和对照组之间的几项血液学参数。
结果
在接受任何一种类型1节段融合手术的患者中，对照组的引流总血量和引流管留置时间均显著少于阿司匹林1组。然而，在接受任何一种类型1节段融合手术的患者中，阿司匹林2组和对照组之间这些指标无显著差异。在接受2节段融合手术的患者中，仅对照组的引流管留置时间显著少于阿司匹林1组。
结论
只有阿司匹林1组（患者在术前3至7天停用阿司匹林）的引流血量和引流管留置时间比对照组多。如果在手术前7天或更长时间停用阿司匹林，与对照组相比，研究参数无差异。
证据级别
3级。
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