前列腺切除或活检围术期停用阿司匹林致心脑血管事件分析并文献复习  

Adverse thrombogenic events induced by discontinuing aspirin in patients during prostate operation： case report and review

作　　者：苏磊[1] 吴芳[1] 何文[1] 

机构地区：[1]中山大学附属第一医院老年病科,广州510000

出　　处：《中华老年医学杂志》2012年第11期941-942,共2页Chinese Journal of Geriatrics

摘　　要：目的研究前列腺切除／活检围术期抗血小板药物阿司匹林对于血栓栓塞性疾病的防治作用。方法回顾性分析2009年7月1日至2012年7月9日在中山大学附属第一医院住院期间诊断为良性前列腺增生（或前列腺恶性肿瘤）并存急性冠状动脉综合征（或急性脑梗死）的342例患者，描述其中4例良性前列腺增生住院期间发生急性心脑血管疾病患者的临床特点及转归。结果4例患者平均年龄（78．8±6．1）岁，其中3例患者在围术期间未使用阿司匹林后发生急性缺血性脑卒中，1例患者因肉眼血尿停用阿司匹林后发生急性非ST段抬高型心肌梗死。4例患者从入院到发病的平均时间为（15．0±10．5）d，所有患者在入院时均未服用非那雄胺治疗。结论前列腺切除或活检围术期患者停用阿司匹林可能与急性心脑血管栓塞事件的发生有关。Objective To determine the incidence of thrombogenic events during the prostate operation period in patients discontinuing aspirin. Methods Among a retrospective cohort of 342 patients admitted in our institution for benign prostatic hyperplasia （or prostate cancer）, combined with acute coronary syndrome （or stroke）, we studied 4 patients who had not been taking aspirin before thrombogenic vascular event. Data on age, sex, vascular disease risk factors, and clinical outcome were collected. Results The 4 patients＇ mean age was 78.8±5.9 years. Each patient had at least two following risk factors： atrial fibrillation, old cerebral infarction and type 2 diabetes. 80% patients had a clinical history of hypertension. 2 of the 4 patients stopped aspirin before a surgical procedure and developed acute ischemic stroke and acute myocardial infarction, separately. The other two patients developed acute ischemic stroke without aspirin prescription. The median time between admission and thrombogenic events was 15.5 ± 10.5 days. All patients were not given finasteride on admission. Conclusions This study should alert clinicians to know the risk of aspirin withdrawl perioperatively in patients at high risk of cardiovascular and cerebrovascular diseases.

关 键 词：前列腺增生 阿司匹林 卒中 心肌梗死 

分 类 号：R699[医药卫生—泌尿科学]