腹腔镜保留肾单位手术围术期预防性使用抗凝药物的安全性  

Safety of perioperative prophylactic anticoagulation in laparoscopic nephron-sparing surgery

作　　者：钟文文 叶雷 邱文锋 王德娟 邱剑光 Zhong Wenwen;Ye Lei;Qiu Wenfeng;Wang Dejuan;Qiu Jianguang(Department of Urology,the Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou 510655,China)

机构地区：[1]中山大学附属第六医院泌尿外科,广州510665

出　　处：《新医学》2022年第7期480-483,共4页Journal of New Medicine

基　　金：广东省自然科学基金(2019A1515010386)。

摘　　要：目的分析腹腔镜保留肾单位手术患者在围术期预防性使用抗凝药物的安全性。方法回顾性分析接受腹腔镜保留肾单位手术的84例患者资料,包括其基线资料及术中出血量、术中输血率、术后再次出血发生率、术后血红蛋白下降值及术后住院时间等。比较围术期预防性使用抗凝药物患者(药物组,50例)与未使用抗凝药物患者(非药物组,34例)的上述指标,以评估围术期预防性使用抗凝药物的安全性。结果药物组与非药物组的术中出血量[50.0(30.0,100.0)mL vs.50.0(45.0,100.0)mL]、术中输血率(0 vs.2.9%)、术后再次出血发生率(4.0%vs.2.9%)、术后血红蛋白下降值[14.0(8.0,23.0)g/L vs.17.7(9.3,28.5)g/L]及术后住院时间[6.0(5.0,7.0)d vs.7.0(4.0,9.3)d]比较差异均无统计学意义(P均>0.05)。结论腹腔镜保留肾单位手术患者在围术期预防性抗凝药物安全可行。Objective To analyze the safety of perioperative prophylactic anticoagulant therapy in patients undergoing laparoscopic nephron-sparing surgery.Methods Clinical data of 84 cases underwent laparoscopic nephron-sparing surgery were retrospectively analyzed.The baseline data,intraoperative blood loss,intraoperative blood transfusion rate,postoperative rebleeding rate,postoperative hemoglobin reduction value,and postoperative length of hospital stay were recorded.These parameters were statistically compared between patients treated with perioperative prophylactic anticoagulant therapy(medicine group,n=50)and without perioperative prophylactic anticoagulant therapy(non-medicine group,n=34).Results There was no significant difference in intraoperative blood loss(50.0(30.0,100.0)mL vs.50.0(45.0,100.0)mL),intraoperative blood transfusion rate(0 vs.2.9%),postoperative rebleeding rate(4.0%vs.2.9%),postoperative hemoglobin reduction value(14.0(8.0,23.0)g/L vs.17.7(9.3,28.5)g/L),and postoperative length of hospital stay(6.0(5.0,7.0)d vs.7.0(4.0,9.3)d)between the medicine and nonmedicine groups(all P>0.05).Conclusion Perioperative prophylactic anticoagulation is safe and feasible for patients undergoing laparoscopic nephron-sparing surgery.

关 键 词：保留肾单位手术 腹腔镜 预防性 抗凝药物 安全性 

分 类 号：R699.2[医药卫生—泌尿科学]