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经皮肾镜围手术期的阿司匹林治疗及护理

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摘要 目的研究心血管疾病高危患者在持续阿司匹林治疗期间行经皮肾镜手术(PCNL)的可行性、安全性。方法回顾性分析2014年1月至2015年3月由同一术者所行的69例经皮肾镜手术患者临床资料。结果未停药组28例患者中结石取尽23例,平均手术时间(122±12)min,出血量(236±24)ml,其中1例患者术后需输血治疗,术后平均住院(2.9±0.5)d。对照组41例患者中结石取尽34例,平均手术时间(111±13)min,出血量(212±22)ml,术后平均住院(2.7±0.4)d。两组患者在清石率、手术时间、出血量、术后住院日等方面差异均无统计学意义(P〉0.05)。两组患者均无心血管疾病发生,术中、术后无其他手术并发症,无术后持续性肾出血,未进行肾血管栓塞介入治疗。结论在拟行经皮肾镜手术的心血管病高危患者中,在围手术期护理监护下持续应用阿司匹林是安全可行的。 Objective To determine the feasibility, safety and nursing care of performing percutaneous nephrolithotomy ( PCNL ) in highcardiovascular risk patients remaining on aspirin therapy. Methods The clinical data of 69 patients who underwent percutaneous renal surgery from March 2015 to January 2014 were analyzed retrospectively. Results The on-aspirin group included 28 PCNLs, while the off-aspirin group included 34 PCNLs. There were no differences between groups in terms of operative time [ ( 122 ± 12 ) minutes vs ( 111± 13 ) minutes ] , bleeding volume [ ( 236± 24 ) ml vs ( 212± 22 ) ml ] , stone-free rate ( 82.1% vs 82.91% ) , median length of postoperative hospitalization [ ( 2.9 ± 0.5 ) d vs ( 2.7± 0.4 ) d ] , transfusion rate ( 3.5% vs 0 ) , or total complications ( P〉0.05 ) . No patient experienced a thromboembolic event and none experienced delayed renal bleeding. Conclusions PCNL can be performed safely and effectively in high cardiovascular risk patients continuing aspirin perioperatively.
出处 《浙江临床医学》 2017年第2期362-363,366,共3页 Zhejiang Clinical Medical Journal
关键词 经皮肾镜 阿司匹林 护理 PCNL Aspirin Nursing care
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