腹腔镜胆囊切除患者围术期使用阿司匹林对患者凝血及胆囊运动功能的影响

目的探讨围术期使用阿司匹林对腹腔镜胆囊切除患者凝血功能、胆囊运动及心脑血管并发症的影响。方法选择2011年3月至2015年6月收治的胆囊结石患者80例,按照随机数字法分为两组,各40例,观察组患者入组后随即使用阿司匹林,对照组使用空白胶囊,每天晨起口服1次,直至手术前晚。应用SPSS13.0进行分析,两组干预前后胆囊体积、收缩率及排空指数比较,凝血功能比较,手术时间及术中出血比较等计量资料以均数±标准差(x珋±s)表示,使用t检验;两组围术期并发症比较采用χ~2检验,P0.05差异有统计学意义。结果干预前两组胆囊体积、胆囊收缩率及胆囊排空指数差异无统计学意义(P0.05)。干预后:观察组胆囊体积小于干预前及对照组(t=32.540和31.455,P均=0.000);胆囊收缩率高于治疗前及对照组(t=79.008和79.968,P均=0.000),胆囊排空指数高于治疗前对照组(t=6.548和4.249,P均=0.000)。两组手术时间及术中出血比较差异无统计学意义(P0.05)。观察组发生心肌缺血、心肌梗塞、脑梗死及下肢深静脉血栓的总比例显著低于对照组(χ~2=5.806,P0.05)。结论腹腔镜下胆囊切除手术,围术期使用阿司匹林能有效减小胆囊体积,促进胆囊排空,且对患者凝血功能无影响,同时还能减少围术期心脑血管并发症。

The effect of the using of aspirin with the blood coagulation and gallbladder motor function of laparoscopic cholecystectomy

Objective To investigate the effect of aspirin taken during the perioperative period on blood coagulation and gallbladder motor function in patients who received laparoscopic cholecystectomy . Methods 80 cases from March 2011 to June 2015 were randomly divided into two groups , with 40 cases in each group .The observation group was immediately used of aspirin , while the control group was oral capsules in one day morning until the night before surgery .SPSS13.0 was used to analyze the gallbladder volume , shrinkage and emptying index .Operative time, blood loss coagulation, platelet count and other measurement data were presented as mean ±standard deviation ( x珋±s ) and were compared by t test; perioperative complications in the two groups were compared using the χ2 test.P <0.05 was considered statistically significant . Results Before the intervention , gallbladder volume , gallbladder and gallbladder emptying rate index between the two groups had no significant difference (P>0.05).After the intervention, the gallbladder volume in the observation group was less than that in thebefore and control group after intervention (t=32.540 and 31.455, P=0.000).Cholecystokinin in the observation group was higher than that in the before and control group after intervention (t=79.008 and 79.968, P=0.000).Gallbladder emptying index in the observation group was higher than that in the before and control group after intervention (t=6.548 and 4.249, P=0.000).Blood loss and operative time between the two groups had no difference (P>0.05).The myocardial ischemia, the total proportion of myocardial infarction , cerebral infarction and deep vein thrombosis in the observation group were lower than those in the control group (χ2 =5.806, P<0.05). Conclusion Perioperative aspirin taken during the perioperative period of laparoscopic cholecystectomy can effectively reduce the volume of the gallbladder and promote gallbladder emptying , and it has no effect on coagulation in patients . Therefore , it can reduce the perioperative cardiovascular complications .