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[术前阿司匹林治疗——肾移植的禁忌证?]

[Preoperative aspirin therapy--a contraindication for kidney transplantation?].

作者信息

Werner W, Schubert J

机构信息

Klinik und Poliklinik für Urologic, Friedrich-Schiller-Universität Jena.

出版信息

Zentralbl Chir. 1997;122(5):374-7.

PMID:9334099
Abstract

INTRODUCTION

The influence of ASA treatment on haemostasis is still debated. There are doubts in case of emergency operations, especially in transplant patients, concerning dosage and change of medication.

METHODS

Our results are based on an analysis of the therapeutical behavior in German transplantation centers. The question of transplant suitability, dosage and haemostatic effects will be discussed in comparison to the literature.

RESULTS

85.7% of the transplantation centers perform the operation despite of and under ASA treatment. In these cases an increased bleeding tendency is tolerated and observed in 33.3% of the centers. An increased mortality has not been reported. Most of the transplantation centers accept a dosage of 100 mg ASA daily. Only 14.3% of the transplantation centers refuse the operation in ASA treated patients.

CONCLUSIONS

Correctly indicated ASA treatment (cardiac arrhythmia, patients with embolism or thrombosis) isn't a contraindication for renal transplantation (daily dosage up to 100 mg). In elective cases however, a preoperative change of the medication is recommended, e.g. the use of heparin instead of ASA.

摘要

引言

阿司匹林治疗对止血的影响仍存在争议。在急诊手术中,尤其是移植患者,对于药物剂量和用药调整存在疑问。

方法

我们的结果基于对德国移植中心治疗行为的分析。将结合文献讨论移植适用性、剂量和止血效果等问题。

结果

85.7%的移植中心在阿司匹林治疗期间或治疗下进行手术。在这些情况下,33.3%的中心容忍并观察到出血倾向增加。尚未有死亡率增加的报道。大多数移植中心接受每日100毫克阿司匹林的剂量。只有14.3%的移植中心拒绝为接受阿司匹林治疗的患者进行手术。

结论

正确使用阿司匹林治疗(用于心律失常、有栓塞或血栓形成的患者)并非肾移植的禁忌症(每日剂量高达100毫克)。然而,在择期手术中,建议术前调整用药,例如使用肝素替代阿司匹林。

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