在 inguinal hernia 修复中持续使用抗凝剂 - - 系统性审查和元分析
Gustavo Magalhães Albuquerque1, Maria Clara Morais2, Denise Padilha Abs de Almeida3
1Faculdade Pernambucana de Saúde, Recife, Brazil.
Hernia : the journal of hernias and abdominal wall surgery
|September 23, 2025
概括
在开放的 inguinal 修复期间的外科手术抗凝药增加了血瘤的风险和住院时间. 然而,手术部位感染和血栓栓塞事件的风险在抗凝血和非抗凝血患者之间没有显著差异.
科学领域:
- 一般外科 整体外科
- 血管外科 血管外科
- 在外科手术期间的医学.
背景情况:
- 由于出血与血栓栓塞的风险,为修复 inguinal hernia 进行外科手术期间的抗凝管理受到争议.
- 需要基于证据的策略,以确保安全有效的患者管理.
- 对抗凝血剂与非抗凝血剂患者的术后结果的比较数据有限.
研究的目的:
- 分析在 inguinal 修复期间使用抗凝剂的现有数据.
- 为了比较手术后的结果,在患者和停用抗凝药.
- 在这个患者群体中评估术后抗凝剂的风险和益处.
主要方法:
- 在主要数据库 (PubMed,EMBASE,ClinicalTrials.gov,Cochrane Library) 中进行了全面的文献搜索.
- 包括观察性研究和临床试验,比较在 inguinal 修复中持续抗凝药与没有抗凝药.
- 主要结局是血瘤形成和手术干预;次要结局包括血清瘤,SSI,手术时间和停留时间.
主要成果:
- 对四项观察性研究 (1384名患者) 的分析显示,抗凝血患者的血液瘤形成风险较高 (RD 0.06;p<0.00001).
- 血液瘤干预率各不相同,两项研究没有显示差异,两项研究显示抗凝组的干预率更高.
- 服用抗凝血剂的患者经历了更长的手术时间和住院时间,但血清瘤或SSI率没有显著差异.
结论:
- 在开放的 inguinal 修复期间的外科手术抗凝药与增加的血瘤风险,手术时间和住院时间有关.
- 血清瘤形成,手术部位感染和血栓栓塞事件在各组之间没有显著差异.
- 对于接受 inguinal hernia 修复的患者来说,仔细考虑抗凝管理至关重要.
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