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单纯腰椎减压持续低剂量阿司匹林治疗的安全性。

Safety of Continuous Low-Dose Aspirin Therapy for Lumbar Decompression Alone.

作者信息

Inoue Tetsuji

机构信息

Department of Orthopedic Surgery, Kumamoto Chuo Hospital, Kumamoto, Japan.

出版信息

Spine Surg Relat Res. 2024 Aug 22;9(2):195-201. doi: 10.22603/ssrr.2024-0168. eCollection 2025 Mar 27.

Abstract

INTRODUCTION

Whether the benefits of continued perioperative aspirin therapy in spinal surgery outweigh the risk of perioperative complications remains unclear. This study evaluates the perioperative effects of continuous low-dose aspirin treatment in patients who underwent lumbar decompression alone.

METHODS

This single-institute retrospective study included patients who underwent lumbar decompression for L1/2-L5/S1 lesions. The patient characteristics, perioperative parameters, and complications were compared between 103 patients who continued to take 100 mg/day aspirin during the perioperative period (aspirin group) and 653 patients who did not take antiplatelet or anticoagulant drugs (nonaspirin group).

RESULTS

A significantly higher proportion of the patients in the aspirin group were males. The patients in the aspirin group had significantly lower preoperative hemoglobin levels than those in the non-aspirin group (P=0.001 and P=0.044, respectively). No significant differences were detected between the groups in terms of the number of disc decompression levels, duration of surgery, intraoperative blood loss, postoperative drainage volume, number of reoperations required for epidural hematoma formation, or perioperative blood transfusions. No cardiovascular or cerebrovascular ischemic events occurred in either group.

CONCLUSIONS

Continuous low-dose aspirin therapy alone during the perioperative period for lumbar decompression did not increase perioperative bleeding or the risk of bleeding-related complications. In conclusion, continuous low-dose aspirin treatment may be acceptable for use in preventing the increased risk of cardiovascular disease caused by aspirin withdrawal in patients undergoing lumbar decompression.

摘要

引言

脊柱手术围手术期持续使用阿司匹林治疗的益处是否超过围手术期并发症的风险尚不清楚。本研究评估了单纯接受腰椎减压手术患者围手术期持续低剂量阿司匹林治疗的效果。

方法

这项单机构回顾性研究纳入了因L1/2-L5/S1节段病变接受腰椎减压手术的患者。比较了围手术期持续服用100毫克/天阿司匹林的103例患者(阿司匹林组)和未服用抗血小板或抗凝药物的653例患者(非阿司匹林组)的患者特征、围手术期参数和并发症。

结果

阿司匹林组男性患者比例显著更高。阿司匹林组患者术前血红蛋白水平显著低于非阿司匹林组(分别为P=0.001和P=0.044)。两组在椎间盘减压节段数、手术时长、术中失血量、术后引流量、硬膜外血肿形成所需再次手术次数或围手术期输血方面未检测到显著差异。两组均未发生心血管或脑血管缺血事件。

结论

腰椎减压手术围手术期单纯持续低剂量阿司匹林治疗不会增加围手术期出血或出血相关并发症的风险。总之,对于接受腰椎减压手术的患者,持续低剂量阿司匹林治疗可用于预防因停用阿司匹林导致的心血管疾病风险增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a62/11983120/a90bc64a21fe/2432-261X-9-0195-g001.jpg

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