陈俊鹏;肖扬;伍旭辉;张朝贵;李健;曾强;

• 1:南华大学附属娄底医院骨科

摘要(Abstract)：

深静脉血栓是关节置换术后一种潜在的致命性并发症。近年来,阿司匹林作为一种新型抗血栓药物兴起。阿司匹林由于它的方便、便宜、耐受性好倍受广大医生的喜欢。但关于阿司匹林抗血栓的有效性、安全性仍争议较多。本文就阿司匹林抗血栓的机制、有效性、安全性、并发症、使用剂量做一综述。

关键词(KeyWords)： 阿司匹林;关节置换术;深静脉血栓

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 陈俊鹏;肖扬;伍旭辉;张朝贵;李健;曾强;

Email:

DOI:

参考文献(References)：

• [1]Quinlan DJ,Eikelboom JW,Dahl OE,et al.Association between asymptomatic deep vein thrombosis detected by venography and symptomatic venous thromboembolism in patients undergoing elective hip or knee surgery[J].J Thromb Haemost,2007,5(7):1438-1443.
• [2]Howie C,Hughes H,Watts AC.Venous thromboembolism associated with hip and knee replacement over a ten-year period:a population-based study[J].J Bone Joint Surg Br,2005,87(12):1675-1680.
• [3]Falck-Ytter Y,Francis CW,Johanson NA,et al.Prevention of VTE in orthopedic surgery patients:antithrombotic therapy and prevention of thrombosis,9th ed:American College of Chest Physicians Evidence-Based Clinical Practice Guidelines[J].Chest2012,141:278-325.
• [4]Parvizi J,Azzam K,Rothman RH.Deep venous thrombosis prophylaxis for total joint arthroplasty:American Academy of Orthopaedic Surgeons guidelines[J].J Arthroplasty,2008,23(7):2-5.
• [5]Hirsh J.Oral anticoagulant drugs[J].N Engl J Med,1991,3241865-1875.
• [6]Jameson SS,Baker PN,Charman SC,et al.The effect of aspirin and low-molecular-weight heparin on venous thromboembolism after knee replacement:a non-randomised comparison using National Joint Registry Data[J].J Bone Joint Surg Br,2012,94:914-918.
• [7]Lieberman JR,Pensak MJ.Prevention of venous thromboembolic disease after total hip and knee arthroplasty[J].J Bone Joint Surg Am,2013,95:1801-1811.
• [8]Lotke PA,Palevsky H,Keenan AM,et al.Aspirin and warfarin for thromboembolic disease after total joint arthroplasty[J].Clin Orthop,1996:251-258.
• [9]Gesell MW,González DVA,BartoloméGS,et al.Safety and efficacy of multimodal thromboprophylaxis following total knee arthroplasty:a comparative study of preferential aspirin vs.routine coumadin chemoprophylaxis[J].J Arthroplasty,2013,28:575-579.
• [10]Huang R,Buckley PS,Scott B,et al.Administration of aspirin as a prophylaxis agent against venous thromboembolism results in lower incidence of periprosthetic joint infection[J].J Arthroplasty2015,30(1):39-41.
• [11]Raphael IJ,Tischler EH,Huang R,et al.Aspirin:an alternative for pulmonary embolism prophylaxis after arthroplasty[J].Clin Orthop,2014,472(472):482-488.
• [12]Lotke PA,Lonner JH.The benefit of aspirin chemoprophylaxis for thromboembolism after total knee arthroplasty[J].Clin Orthop2006,452(452):175-180.
• [13]Cattaneo M.Antiplatelet agents[J].Hematol J,2004,5(Suppl 3)170-174.
• [14]Becattini C,Agnelli G.Aspirin for prevention and treatment of venous thromboembolism[J].Blood Rev,2014,28(1):103-108.
• [15]Campbell CL,Smyth S,Montalescot G,et al.Aspirin dose for the prevention of cardiovascular disease:a systematic review[J].JA-MA,2007,297:2018-2024.
• [16]Patrono C,Andreotti F,Arnesen H,et al.Antiplatelet agents for the treatment and prevention of atherothrombosis[J].Eur Heart J2011,32:2922-2932.
• [17]Vandvik PO,Lincoff AM,Gore JM,et al.Primary and secondary prevention of cardiovascular disease:antithrombotic therapy and prevention of thrombosis,9th ed:American College of Chest Physicians Evidence-Based Clinical Practice Guidelines[J].Chest2012,141:637-668.
• [18]Westrich GH,Bottner F,Windsor RE,et al.Vena Flow plus lovenox vs venaflow plus aspirin for thromboembolic disease prophylaxis in total knee arthroplasty[J].J Arthroplasty,2006,21:139-143.
• [19]White RH,Meehan JP,Romano PS.Re:does aspirin have a role in venous thromboembolism prophylaxis in total knee arthroplasty patients[J].J Arthroplasty,2010,25:667-668.
• [20]Becattini C,Agnelli G,Schenone A,et al.Aspirin for preventing the recurrence of venous thromboembolism[J].N Engl J Med,2012,366:1959-1967.
• [21]González DVA,Serota A,Go G,et al.Venous thromboembolism is rare with a multimodal prophylaxis protocol after total hip arthroplasty[J].Clin Orthop,2006,444:146-153.
• [22]Nam D,Nunley RM,Johnson SR,et al.Mobile compression devices and aspirin for VTE prophylaxis following simultaneous bilateral total knee arthroplasty[J].J Arthroplasty,2015,30:447-450.
• [23]Levine MN,Raskob G,Beyth RJ,et al.Hemorrhagic complications of anticoagulant treatment:the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy[J].Chest,2004,126:287-310.
• [24]Vulcano E,Gesell M,Esposito A,et al.Aspirin for elective hip and knee arthroplasty:a multimodal thromboprophylaxis protocol[J].Int Orthop,2012,36:1995-2002.
• [25]Cusick LA,Beverland DE.The incidence of fatal pulmonary embolism after primary hip and knee replacement in a consecutive series of 4253 patients[J].J Bone Joint Surg Br,2009,91:645-648.
• [26]Pellegrini VD,Sharrock NE,Paiement GD,et al.Venous thromboembolic disease after total hip and knee arthroplasty:current perspectives in a regulated environment[J].Instr Course Lect,2008,57:637-661.
• [27]Poultsides LA,Gonzalez DVA,Memtsoudis SG,et al.Meta-analysis of cause of death following total joint replacement using different thromboprophylaxis regimens[J].J Bone Joint Surg Br,2012,94:113-121.
• [28]Sachs RA,Smith JH,Kuney M,et al.Does anticoagulation do more harm than good?A comparison of patients treated without prophylaxis and patients treated with low-dose warfarin after total knee arthroplasty[J].J Arthroplasty,2003,18:389-395.
• [29]Sharrock NE,Gonzalez DVA,Go G,et al.Potent anticoagulants are associated with a higher all-cause mortality rate after hip and knee arthroplasty[J].Clin Orthop,2008,466:714-721.
• [30]Callaghan JJ,Warth LC,Hoballah JJ,et al.Evaluation of deep venous thrombosis prophylaxis in low-risk patients undergoing total knee arthroplasty[J].J Arthroplasty,2008,23(1):20-24.
• [31]Patel VP,Walsh M,Sehgal B,et al.Factors associated with prolonged wound drainage after primary total hip and knee arthroplasty[J].J Bone Joint Surg Am,2007,89(1):33-38.
• [32]Catella-Lawson F,Reilly MP,Kapoor SC,et al.Cyclooxygenase inhibitors and the antiplatelet effects of aspirin[J].N Engl J Med,2001,345:1809-1817.
• [33]Patrono C,García RLA,Landolfi R,et al.Low-dose aspirin for the prevention of atherothrombosis[J].N Engl J Med,2005,353:2373-2383.
• [34]Stewart DW,Freshour JE.Aspirin for the prophylaxis of venous thromboembolic events in orthopedic surgery patients:a comparison of the AAOS and ACCP guidelines with review of the evidence[J].Ann Pharmacother,2013,47(1):63-74.
• [35]Leali A,Fetto J,Moroz A.Prevention of thromboembolic disease after non-cemented hip arthroplasty.A multimodal approach[J].Acta Orthop Belg,2002,68:128-134.
• [36]Reitman RD,Emerson RH,Higgins LL,et al.A multimodality regimen for deep venous thrombosis prophylaxis in total knee arthroplasty[J].J Arthroplasty,2003,18:161-168.
• [37]Gelfer Y,Tavor H,Oron A,et al.Deep vein thrombosis prevention in joint arthroplasties:continuous enhanced circulation therapy vs low molecular weight heparin[J].J Arthroplasty,2006,21:206-214.
• [38]Daniel J,Pradhan A,Pradhan C,et al.Multimodal thromboprophylaxis following primary hip arthroplasty:the role of adjuvant intermittent pneumatic calf compression[J].J Bone Joint Surg Br,2008,90:562-569.
• [39]Kulshrestha V,Kumar S.DVT prophylaxis after TKA:routine anticoagulation vs risk screening approach-a randomized study[J].JArthroplasty,2013,28:1868-1873.
• [40]Zou Y,Tian S,Wang Y,et al.Administering aspirin,rivaroxaban and low-molecular-weight heparin to prevent deep venous thrombosis after total knee arthroplasty[J].Blood Coagul Fibrinolysis,2014,25:660-664.
• [41]Lussana F,Squizzato A,Permunian ET,et al.A systematic review on the effect of aspirin in the prevention of post-operative arterial thrombosis in patients undergoing total hip and total knee arthroplasty[J].Thromb Res,2014,134:599-603.