抗凝剂对前列腺手术出血并发症影响的Meta分析  

Meta analysis on effect of anticoagulant drugs on bleeding complication in prostatic surgery

作　　者：王家武[1] 张成瑶[2] 谭光忠[1] 陈文锴[1] 杨波[1] 谭丹[1] 

机构地区：[1]重钢总医院泌尿外科,400080 [2]重庆医科大学附属第一医院普外科,400016

出　　处：《重庆医学》2013年第8期894-898,共5页Chongqing medicine

摘　　要：目的系统评价抗凝药物对泌尿外科手术出血并发症的影响。方法收集国内外有关术前停用抗凝药物与术前继续使用抗凝药物对泌尿外科手术出血并发症的影响的临床对照试验文献。对符合纳入标准的研究使用统计软件RevMan5.0进行Meta分析。结果经筛选最后纳入11篇文献,受试患者共包括4 345例,进行Meta分析。所有纳入研究的病例均具有可比性。与对照组比较,试验组患者:(1)在前列腺切除或根治术患者,术前使用抗凝药物比术前停用抗凝药物的出血风险增加了1.42倍,其95%可信区间为(1.10,5.32);(2)术前使用抗凝药物并不会增加前列腺穿刺活检的出血风险,其95%可信区间为(0.90,1.51)。结论在前列腺切除术中,术前停用抗凝药物可以减少手术出血并发症的风险,而在前列腺穿刺活检术中抗凝药物不影响术后出血并发症的风险。Objective To systematically evaluate the effect of anticoagulant drugs on bleeding complications in urologic surgery. Methods The literature of clinical controlled trials on preoperative anticoagulant drugs withdrawal and continuing preoperative an ticoagulant drugs at home and abroad were retrieved and collected. The trials according with the inclusion criteria were performed the Meta analysis by the Manger 5.0 statistical software. Results 11 trials were screened out,including 4 34,5 tested cases,and per- formed the Meta analysis. All the inclusion cases were comparable. Compared with the control group, （1） the cases with prostatec tomy or radical prostatectomy,continuing preoperative anticoagulants increased the bleeding risk by 1.42 times than preopertive an- ticoagulants withdrawal, the 95 %confidence interval was 1.10,5.32;（2） Continuing preoperative anticoagulants did not increase the bleeding risk of prostate aspiration biopsy, the 95% confidence interval was 0. 90, 1. 51. Conclusion Preopertive anticoagulant drugs withdrawal can reduce the risk of surgical bleeding complications in prostatectomy. But anticoagulants do not affect the risk of postoperative bleeding complications in prostate biopsy.

关 键 词：前列腺 外科学 失血 手术 抗凝药 META分析 

分 类 号：R699[医药卫生—泌尿科学]