阿司匹林预防下肢关节置换术后静脉血栓栓塞症效果的meta分析  

Effect of aspirin for prevention venous thromboembolism after lower limb joint replacement:a meta-analysis

作　　者：林洁 王彬[1] LIN Jie;WANG Bin(Department of Anesthesiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院麻醉科

出　　处：《现代医药卫生》2019年第11期1609-1612,共4页Journal of Modern Medicine & Health

基　　金：国家卫生健康委员会临床重点专科建设项目[财社(2011)17D号];重庆市卫生健康委员会医学重点学科建设项目[渝卫科教(NO.2007)2号]

摘　　要：目的采用meta分析评价阿司匹林对下肢关节置换术后静脉血栓栓塞症(VTE)的预防效果。方法检索PubMed、中国知网、维普及万方数据库,收集所有阿司匹林预防下肢关节置换术后VTE相关随机对照试验(RCT)研究文献,经文献筛选、数据提取、纳入文献质量评价后,采用RevMan5.3软件进行meta分析。结果最终纳入9个RCT研究文献,共1 532例研究对象。meta分析结果显示,阿司匹林组与低分子肝素组相比,深静脉血栓形成(DVT)发生率(RR=1.17,95%CI:0.77~1.79,P=0.46)、肺动脉血栓栓塞(PTE)发生率(RR=1.36,95%CI:0.08~22.2,P>0.05)、血红蛋白下降量(WMD=-5.45,95%CI:-14.90~3.99,P=0.26),以及切口并发症发生率(RR=0.76,95%CI:0.28~2.06,P=0.59)比较差异均无统计学意义;阿司匹林组与口服抗凝药组相比,DVT发生率(RR=2.17,95%CI:0.42~11.15,P=0.35)及切口并发症发生率(RR=0.37,95%CI:0.07~1.87,P=0.23)比较差异均无统计学意义;阿司匹林组与空白对照组相比,阿司匹林能降低术后DVT发生率(RR=0.44,95%CI:0.29~0.66,P<0.000 1)。结论阿司匹林可预防下肢关节置换术后DVT、PTE及切口并发症,对血红蛋白下降量的影响与低分子肝素和口服抗凝药无显著差异。Objective To evaluate the efficacy of aspirin for preventing venous thromboembolism(VTE) after lower limb joint replacement by using meta-analysis. Methods PubMed, CNKI, VIP and WANGFANG databases were retrieved to collect all randomized controlled trail(RCT) studies about the effects of aspirin for prevention of VTE after lower extremity joint replacement.After screening, data extraction and evaluation of the quality of included literature, meta-analysis was conducted by using RevMan5.3. Results Nine RCT studies and 1 532 subjects were eventually included.The results of meta-analysis showed that there were no significant differences between aspirin group and low-molecular-weight heparin( LMWH) group in the incidence of deep vein thrombosis(DVT, RR =1.17,95% CI :0.77-1.79, P =0.46),the incidence of pulmonary thromboembolism(PTE. RR =1.36,95% CI :0.08-22.2, P >0.05), hemoglobin decrease( WMD =-5.45,95% CI :-14.90-3.99, P =0.26) and incisional complication incidence( RR =0.76,95% CI :0.28-2.06, P =0.59).There were no significant differences between aspirin group and oral anticoagulant group in the incidence of DVT( RR =2.17,95% CI :0.42-11.15, P =0.35] and the incidence of incision complications( RR =0.37,95% CI :0.07-1.87, P =0.23).There was significant difference between aspirin group and the blank control group in the incidence of postoperative DVT( RR =0.44,95% CI :0.29-0.66, P <0.000 1). Conclusion Aspirin could prevent the incidence of DVT, PTE and incision complications,and be with the same effects with LMWH and oral anticoagulant on hemoglobin decrease.

关 键 词：阿司匹林 关节置换术 静脉血栓栓塞症 META分析 

分 类 号：R619.2[医药卫生—外科学] R68[医药卫生—临床医学]