Brit J Surg:阿司匹林与肝切除术后出血相关并发症!

2018-03-13 xing.T MedSci原创

由此可见,这项观察性研究表明在择期的肝脏手术后,阿司匹林的继续使用与较高的出血相关的并发症无关。

抗血小板治疗后肝脏切除的手术风险尚不清楚。近日,外科疾病领域权威杂志British Journal of Surgery上发表了一篇研究文章,该项研究试图在有良好平衡匹配的队列中评估择期肝切除术继续或不继续接受阿司匹林治疗的结局。

这些数据取自一项多中心前瞻性观察性研究。阿司匹林与对照组采用非标准化方法和倾向评分(PS)匹配分析进行比较。主要的结局为严重的出血。其他分析结局包括术中输血、总出血、主要并发症、综合并发症指数(CCI)评分、血栓栓塞并发症、缺血性并发症和死亡率。

配对前,阿司匹林组有118例患者,对照组1685例受试者。ASA分级、心血管疾病、既往心绞痛病史、血管成形术、糖尿病、维生素K拮抗剂的使用、肝硬化和肝切除术类型在组间具有显著差异。PS匹配后,每组纳入了108例患者。阿司匹林组和对照组在严重出血(6.5 vs. 5.6%;比值比(OR)1.18, 95%CI为0.38-3.62)、术中输血(23.4 vs. 23.7%;OR为0.98, 95%CI为0.51-1.87)、总体出血(10.2 vs. 12.0%;OR为0.83, 95%CI为0.35-1.94)、CCI评分(24 vs. 28;P=0.520)、主要并发症(23.1 vs. 13.9%;OR为1.82, 95%CI为0.92-3.79)和90天的死亡率(5.6 vs. 4.6%;OR为1.21, 95%CI为0.36-4.09)。

由此可见,这项观察性研究表明在择期的肝脏手术后,阿司匹林的继续使用与较高的出血相关的并发症无关。

原始出处:

M. Gelli,et al. Use of aspirin and bleeding-related complications after hepatic resection. British Journal of Surgery.2018. http://onlinelibrary.wiley.com/doi/10.1002/bjs.10697/full

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    2019-01-19 丁鹏鹏
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attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sun Apr 01 07:11:43 CST 2018, time=2018-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296326, encodeId=1a4829632635, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a8f22260741, createdName=121832a9m88暂无昵称, createdTime=Thu Mar 15 06:02:47 CST 2018, time=2018-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1417882, encodeId=3e66141e88214, content=<a href='/topic/show?id=bcb081181dc' target=_blank style='color:#2F92EE;'>#肝切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81181, encryptionId=bcb081181dc, topicName=肝切除术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1bcb3304824, createdName=zexyw02, createdTime=Wed Mar 14 22:42:00 CST 2018, time=2018-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295999, encodeId=5bbb29599918, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/01/15/8213228fe923915543544ad3da7e1c64.jpg, createdBy=6bd82014262, createdName=秀红, createdTime=Wed Mar 14 05:59:06 CST 2018, time=2018-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295852, encodeId=692c2958525b, content=学习了.谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/10/23/557c1f19aaf5459a8405411e38903c4b.jpg, createdBy=dfc02088287, createdName=cscdliu, createdTime=Tue Mar 13 14:24:00 CST 2018, time=2018-03-13, status=1, ipAttribution=)]
    2018-05-08 jyzxjiangqin

    阿司匹林治疗.

    0

  5. 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attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sun Apr 01 07:11:43 CST 2018, time=2018-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296326, encodeId=1a4829632635, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a8f22260741, createdName=121832a9m88暂无昵称, createdTime=Thu Mar 15 06:02:47 CST 2018, time=2018-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1417882, encodeId=3e66141e88214, content=<a href='/topic/show?id=bcb081181dc' target=_blank style='color:#2F92EE;'>#肝切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81181, encryptionId=bcb081181dc, topicName=肝切除术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1bcb3304824, createdName=zexyw02, createdTime=Wed Mar 14 22:42:00 CST 2018, time=2018-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295999, encodeId=5bbb29599918, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/01/15/8213228fe923915543544ad3da7e1c64.jpg, createdBy=6bd82014262, createdName=秀红, createdTime=Wed Mar 14 05:59:06 CST 2018, time=2018-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295852, encodeId=692c2958525b, content=学习了.谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/10/23/557c1f19aaf5459a8405411e38903c4b.jpg, createdBy=dfc02088287, createdName=cscdliu, createdTime=Tue Mar 13 14:24:00 CST 2018, time=2018-03-13, status=1, ipAttribution=)]
    2018-09-10 changfy
  6. 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attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/10/23/557c1f19aaf5459a8405411e38903c4b.jpg, createdBy=dfc02088287, createdName=cscdliu, createdTime=Tue Mar 13 14:24:00 CST 2018, time=2018-03-13, status=1, ipAttribution=)]
    2018-04-01 jyzxjiangqin

    阿司匹林治疗.

    0

  7. 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attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/10/23/557c1f19aaf5459a8405411e38903c4b.jpg, createdBy=dfc02088287, createdName=cscdliu, createdTime=Tue Mar 13 14:24:00 CST 2018, time=2018-03-13, status=1, ipAttribution=)]
    2018-03-15 121832a9m88暂无昵称

    学习了

    0

  8. 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  9. 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attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/10/23/557c1f19aaf5459a8405411e38903c4b.jpg, createdBy=dfc02088287, createdName=cscdliu, createdTime=Tue Mar 13 14:24:00 CST 2018, time=2018-03-13, status=1, ipAttribution=)]
    2018-03-14 秀红

    学习了

    0

  10. 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    2018-03-13 cscdliu

    学习了.谢谢

    0

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