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肺切除术后围手术期继续使用阿司匹林对出血的影响。

Effect of perioperative aspirin continuation on bleeding after pneumonectomy.

机构信息

Department of Thoracic Surgery, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.

Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.

出版信息

Thorac Cancer. 2023 Apr;14(12):1071-1076. doi: 10.1111/1759-7714.14846. Epub 2023 Mar 13.

Abstract

BACKGROUND

To investigate the effect of continuous oral aspirin in perioperative period on bleeding in pneumonectomy.

METHODS

A total of 170 patients who underwent pneumonectomy in our hospital from March 2021 to March 2022 were selected as the study objects. All patients took oral aspirin before surgery and did not take other antiplatelet agent or anticoagulants at the same time. The continuation group included 85 cases and continued to take aspirin 100 mg/day during the perioperative period, and the interruption group included 85 cases who stopped aspirin for 7 days before surgery and 3 days after surgery, without bridging therapy. The intraoperative blood loss, operation time, conversion to thoracotomy rate, postoperative bleeding rate, blood transfusion rate, thrombotic events, postoperative drainage volume, length of hospital stay, and total hospital cost of the two groups were compared.

RESULTS

There were no statistically significant differences in intraoperative blood loss, operative time, rate of conversion to open, postoperative drainage, hospital stay, and cost between the two groups (p > 0.05), and there were no reoperations due to bleeding between the two groups.

CONCLUSIONS

Aspirin should be continued throughout the perioperative period in all high-risk patients requiring pneumonectomy after balancing ischemic-bleeding risks.

摘要

背景

研究围手术期持续口服阿司匹林对全肺切除术出血的影响。

方法

选取 2021 年 3 月至 2022 年 3 月我院收治的 170 例行全肺切除术的患者作为研究对象。所有患者术前均口服阿司匹林,且同时未服用其他抗血小板或抗凝药物。延续组 85 例,围手术期继续服用阿司匹林 100mg/d;中断组 85 例,术前停用阿司匹林 7d,术后停用 3d,未进行桥接治疗。比较两组患者术中出血量、手术时间、中转开胸率、术后出血率、输血率、血栓事件发生率、术后引流量、住院时间、总住院费用。

结果

两组患者术中出血量、手术时间、中转开胸率、术后引流量、住院时间、总住院费用比较,差异均无统计学意义(P>0.05),两组均无因出血再次手术者。

结论

对于需要行全肺切除术的高危患者,在平衡缺血-出血风险后,应在围手术期全程持续使用阿司匹林。

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