阿司匹林用于骨折手术后的血栓塞栓预防
Wei-Lin Liang1, Rui Wang2, Xin He3
1Department of Cardiology, Guangyuan Hospital of Chinese Medicine, Guangyuan, China.
Journal of orthopaedics
|April 14, 2025
概括
在骨折手术后预防死亡,出血或肺栓塞方面,阿司匹林与埃诺沙巴林没有显著的区别. 然而,阿司匹林使用与较高的深静脉血栓形成风险有关.
科学领域:
- 整形外科 整形外科 整形外科
- 心血管医学 心血管医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 静脉血栓栓塞 (VTE) 是骨折手术后的一个关键风险.
- 阿司匹林用于血栓预防,但其安全性和有效性需要进一步评估.
研究的目的:
- 评估阿司匹林在患者骨折后手术中用于静脉瘤预防的安全性和有效性.
- 为了比较阿司匹林与埃诺沙巴林在预防血栓栓塞事件和相关并发症方面.
主要方法:
- 进行了随机对照试验 (RCT) 的元分析.
- 搜索数据库 (PubMed,科学网,科克兰图书馆) 截至2023年1月29日.
- 主要结局:全因死亡,出血. 二次结局:静脉瘤发作 (PE,DVT),手术部位感染. 计算了风险比率 (RR) 和95%置信区间 (CI).
主要成果:
- 包括两个具有高方法质量的RCT (12,540名患者).
- 在所有死因 (RR=1.07,95%CI=0.71-1.59),出血 (RR=0.96,95%CI=0.89-1.05),肺栓塞 (RR=0.96,95%CI=0.72-1.27) 或手术部位感染 (RR=1.12,95%CI=0.87-1.46) 方面没有发现显著差异.
- 与埃诺沙巴林相比,阿司匹林显示深静脉血栓形成的风险更高 (RR=1.48,95%CI=1.16-1.89).
结论:
- 与enoxaparin相比,阿司匹林在主要不良结果中没有显著差异.
- 随着阿司匹林增加DVT的风险,在骨折手术后的血栓预防策略中需要考虑.
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