长期服用阿司匹林患者颅脑手术的策略

目的探讨长期口服阿司匹林患者颅脑手术策略。方法回顾性分析长期口服阿司匹林并接受颅脑手术的96例患者术后发生颅内出血情况及术后硬膜外引流量,并与同期未服用阿司匹林患者进行对比研究。结果服用阿司匹林的96例有5例（5.2%）术后颅内出血,同期未服用阿司匹林4495例中只有12例（0.3%）术后出血,两者比较统计学有显著差异（P〈0.05）,其中术前停用阿司匹林7d以上47例术后颅内出血1例,停用阿司匹林1～6d35例术后出血1例,未停用阿司匹林14例术后出血3例。术前停用阿司匹林的术后硬膜外引流量明显少于未停用阿司匹林者（P〈0.05）。结论长期口服阿司匹林患者应停用阿司匹林7～10d后再行颅脑手术。

Intracranial surgical strategy for the patients with long-term aspirin medication

Objective To explore the intracranial surgical strategies for the patients with long-term aspirin medication.Methods The retrospective analyses were made about the number of postoperative intracranial hemorrhage and the amount of epidural exudates in 96 patients with long-term aspirin medication,and the results were compared with that of the patients without aspirin intake.Results There were 5 cases （5.2%） of intracranial hemorrhage after operation in 96 cases with aspirin medication and 12 cases （0.3%） of postoperative intracranial hemorrhage in 4495 cases without aspirin intake.There was a significant difference between aspirin intake group and non-aspirin intake group （P0.05）.There was 1 case of postoperative intracranial hemorrhage in 47 cases which discontinued aspirin intake more than 7 d before operation;1 case of postoperative intracranial hemorrhage in 35 cases which discontinued aspirin intake 1 to 6 d before operation;3 cases of postoperative intracranial hemorrhage in 14 cases which continued aspirin intake before operation.The amount of epidural exudates in group that discontinued aspirin intake 1~6 d before operation was much more than that in group that discontinued aspirin intake more than 7 d before operation （P0.05）.Conclusion The patients with long-term aspirin medication should discontinue aspirin intake more than 7~10 d before intracranial surgery.