阿司匹林与脑出血术后再出血相关性和不同血小板制剂治疗的临床研究  

Clinical study of relation and treatment with different platelet formulations between aspirin and relapsing haemorrhage after operation in hypertensive cerebral haemorrhage patients

作　　者：李晓卫[1] 孙昭胜[1] 叶艳巧[1] 陈建超[1] 李永谦[1] 赵金恋[1] 宋德余[1] 赵旺淼[1] 毛建辉[1] 

机构地区：[1]河北医科大学附属哈励逊国际和平医院神经外科,河北省衡水市053000

出　　处：《中华神经外科杂志》2010年第4期347-349,共3页Chinese Journal of Neurosurgery

摘　　要：目的探讨阿司匹林与高血压基底节区脑出血术后再出血的相关性和新鲜血小板、冰冻血小板的疗效。方法开颅手术治疗脑出血816例，未应用阿司匹林的为对照组（A组），应用阿司匹林的随机分为三组：B组常规治疗，c组加用冰冻血小板，D组加用新鲜血小板。排除术中止血不彻底患者（共27例）后，A组315例、B组154例、C组160例、D组160例。结果再出血量、死亡率及ADL评分：B组与A、C、D组比较差异有统计学意义（P〈0．01）。A、C、D三组比较差异无统计学意义。结论阿司匹林可增加脑出血术后再出血机会，增加致残率及死亡率；新鲜血小板及冰冻血小板疗效明显，且疗效差异无统计学意义。Objective To explore the relation and clinical efficiency for fresh apheresis platelets and frozen apheresis platelets between aspirin and relapsing haemorrhage after operation in hypertensive basal ganglia cerebral haemorrhage patients. Methods 816 patients with hypertensive basal ganglia cerebral haemorrhage were treated with craniotomy. Patients without aspirin medication before the onset of the disease were chosen as the control group （group A ）. There were 326 cases in group A. The patients used aspirin before the onset of the disease were randonrly assigned to three groups （ group B, C and D）. The patients in group B were given routine therapy without other intervention. On the basis of routine therapy, the patients in group C were received frozen apheresis platelets, and the patients in group D were received fresh apheresis platelets. Except the patients without satisfactory heamostasis during operation, there were 315 patients in group A, 154 patients in group B, 160 patients in group C and 160 patients in group D. Results The rate of relapsing heamorrhage after operation, heamatoma volume of relapsing haemorrhage, death rate and ADL score grades by 6 months follow - up survey in four groups showed that there were more significant difference between group A and group B, group B and group C, group B and group D （ P 〈 O. O1 ）. There was no significant difference between group A and group C, group A and group D, group C and group D （P 〉0.05）. Conclusion Aspirin can increase the chance of relapsing haemorrhage after operation, disablement rate and death rate in hypertensive basal ganglia cerebral haemorrhage patients. The chance of relapsing haemorrhage after operation, disablement rate and death rate can be decreased after using fresh apheresis platelets and frozen apheresis platelets. There was no significant difference of curative effect between used fresh apheresis platelets and frozen one. Fresh apheresis platelets should be used as a first -line therapy.

关 键 词：阿司匹林 高血压基底节区脑出血 术后再出血 新鲜血小板 冰冻血小板 

分 类 号：R651.1[医药卫生—外科学]