Effect Of Aspirin In Postoperation On Middle-aged And Old Patients With Cerebral Hemorrhage

BackgroundThere are many research on the effects of aspirin on neurosurgery in domestic and international,most tend to aspirin could increase the risk of blood loss and postoperative bleeding,but in recent years had studies showed that preoperative continue or discontinue use aspirin intraoperative blood losses,blood transfusion 30-day readmission rate showed no significant difference.Two diametrically opposite results of made whether discontinue use aspirin on preoperative the controversial issue.ObjectiveTo explore the effects of long-term orally enteric coated aspirin in surgeries and prognosis on middle-aged and old patients with cerebral hemorrhage,to find the most reasonable and effective treatment for emergency operation.MethodsA total of 132 patients with cerebral hemorrhage receiving surgery in our hospital of Neurosurgery Department from June 2013 to June 2015 were reviewed and analyzed.The patients were divided into three groups according to whether had long-termly taken enteric coated aspirin before operation:the long-term and regular group(group A,n=38),the long-term and discontinuous group(group B,n=45),and the not-taking group(group C,n=49).The preoperative coagulation function,intraoperative blood loss,72 h postoperative rehaemorrhagia of each group were compared and analyzed.And follow-up the death of one month after operation and the ability of daily life after six months.Statistical analyses were performed using the unpaired t tests and Chi-square test.Evaluate the effects of long-term orally enteric coated aspirin in surgeries and prognosis on middle-aged and old patients with cerebral hemorrhage.Results1.There were no significant difference of general information such as gender,age,GCS score between the three groups.2.The prothrombin time of patients in group A,B,and C were(13.59±0.24)s,(13.36±0.19)s,and(13.12±0.12)s,respectively.The prothrombin time of three groups had no significant difference(P>0.05).The intraoperative blood losses were(707.89±38.02)ml,(711.11±33.93)ml,and(523.47±26.77)ml,respectively.The differences of intraoperative blood losses between group A and group C,and between group B and group C were statistically significant(P<0.05),the differences of intraoperative blood losses between group A and group B,were no statistically significant(P>0.05).And the cases of patients experiencing postoperative rehaemorrhagia were 8 cases(21.05%),9 cases(20.00%),and 2 cases(4.08%).The differences of postoperative rehaemorrhagia rate between group A and group C,and between group B and group C were statistically significant(P<0.05),the differences of postoperative rehaemorrhagia rate between group A and group B,were no statistically significant(P>0.05).3.According to the follow-up 1 month after operation,4 patients died in group A,5 cases and 1 case died in group B and C,respectively.The death rate of one month after operation had no significant difference(P>0.05).After a follow-up of 6 months,mortality rate among three groups had no significant difference(P>0.05).Compared group C with group A and B,the ADL were statistically significant(P<0.05).Conclusion1.Long-term oral administration of enteric coated aspirin can increase the blood loss during cerebral hemorrhage surgeries and enhance the incidence of postoperative rehaemorrhagia.2.The prognosis of patients with cerebral hemorrhage treated with aspirin for a long time is poorer.