在持续低剂量阿司匹林治疗下进行的腰部减压手术的周围手术安全性
Hiromitsu Takaoka1, Ko Takano1, Osamu Matsushige1
1Department of Orthopedic Surgery, New Tokyo Hospital, Matsudo, Japan.
Spine
|March 14, 2025
概括
在接受脊髓手术的患者中,持续服用低剂量阿司匹林 (LDA) 会增加手术期间的血液损失,但不会增加严重出血的风险. 谨慎的管理允许安全地继续LDA治疗腰部减压.
科学领域:
- 神经外科 神经外科
- 心脏病学 心脏病学
- 麻醉学 麻醉学
背景情况:
- 在接受脊髓手术的患者中,对于持续服用低剂量阿司匹林 (LDA) 缺乏共识.
- 之前关于LDA对脊柱手术期间出血的影响的研究已经产生了不一致的结果.
研究的目的:
- 为了调查经手术期间出血和在经过脊髓手术的LDA患者的安全结果.
- 在这个患者群体中评估LDA使用和出血并发症之间的关联.
主要方法:
- 375名腰椎脊柱狭窄症患者的回顾性队列研究 (98名在LDA,207名没有).
- 倾向性得分匹配创造了两个89名患者的组.
- 分析包括手术时间,血液损失,排水量和血红蛋白变化.
主要成果:
- 在LDA组,手术内流失的血量显著增加 (70.3毫升与46.4毫升相比,P=0.003).
- 手术后的血红蛋白在LDA组下降更多 (2.2 g/dL对比1.9 g/dL,P=0.04).
- 没有观察到输血率或严重出血并发症的显著差异.
结论:
- 使用LDA与手术期间血液流失增加和手术后血红蛋白下降更大有关.
- 在经过腰部减压手术的患者中,LDA可能可以安全地继续进行,并经过谨慎管理.
- 研究的局限性包括其观察性,单中心设计,影响了概括性.
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