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[阿司匹林用于预防全髋关节置换术或全膝关节置换术后静脉血栓栓塞的现代方法。一项回顾性试验]

[Modern Approach to the Use of Aspirin in Prevention of Venous Thromboembolism Following Total Hip Arthroplasty or Total Knee Arthroplasty. A Retrospective Trial].

作者信息

Benkovich Vadim, Abialevich Artsiom, Fiterman Maria

机构信息

Department of Joint Arthroplasty, "Yonatan" Center-Israeli Joint and Spine Health Center, Tel Aviv-Yafo, Israel.

Assuta Medical Center, Be'er Sheva, Israel.

出版信息

Acta Chir Orthop Traumatol Cech. 2025 Mar;92(1):21-27. doi: 10.55095/achot2024/070.

Abstract

PURPOSE OF THE STUDY

Given the risk of venous thromboembolism (DVT) and pulmonary embolism (PE) after large joint replacement, the role of thromboprophylaxis is crucial. This retrospective study aims to evaluate the effectiveness of aspirin as thromboprophylaxis in patients undergoing TKA or THA.

MATERIAL AND METHODS

In this retrospective review of a database of patients who underwent total hip and total knee replacements between 2021 and 2023, we divided patients into two groups: those with no anticoagulation therapy before surgery and those on chronic anticoagulant use prior to surgery. The primary endpoint was the number of patients with complications after aspirin use in the postoperative period. We collected patient demographic information, history of anticoagulant use, postoperative anticoagulant usage, comorbidities, type of surgery, reactions to anticoagulants, complications related to thromboembolism, length of hospital stay, and hospital readmissions.

RESULTS

For patients who underwent elective THA or TKA, no significant difference in overall VTE or PE rates was detected when comparing aspirin with other anticoagulants. No mortality events were reported. However, there were differences in bleeding event rates between the aspirin group and other anticoagulant groups.

CONCLUSIONS

Proper patient selection and early postoperative mobilization support the use of aspirin as a thromboprophylaxis therapy. The results of this study confirm that aspirin is a safe alternative to other anticoagulants in the postoperative management of THA and TKA.

摘要

研究目的

鉴于大关节置换术后存在静脉血栓栓塞(DVT)和肺栓塞(PE)的风险,血栓预防的作用至关重要。这项回顾性研究旨在评估阿司匹林在接受全膝关节置换术(TKA)或全髋关节置换术(THA)患者中作为血栓预防措施的有效性。

材料与方法

在对2021年至2023年间接受全髋关节和全膝关节置换术患者数据库的回顾性研究中,我们将患者分为两组:术前未接受抗凝治疗的患者和术前长期使用抗凝剂的患者。主要终点是术后使用阿司匹林后出现并发症的患者数量。我们收集了患者的人口统计学信息、抗凝剂使用史、术后抗凝剂使用情况、合并症、手术类型、对抗凝剂的反应、与血栓栓塞相关的并发症、住院时间和再次入院情况。

结果

对于接受择期THA或TKA的患者,将阿司匹林与其他抗凝剂进行比较时,未发现总体VTE或PE发生率有显著差异。未报告死亡事件。然而,阿司匹林组与其他抗凝剂组之间的出血事件发生率存在差异。

结论

合理的患者选择和术后早期活动支持将阿司匹林用作血栓预防治疗。本研究结果证实,在THA和TKA的术后管理中,阿司匹林是其他抗凝剂的安全替代品。

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