Safety Assessment of Low Molecular Heparin Instead of Anticoagulant in Patients with Inguinal Hernia during Perioperative Period_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZHANGJie , LIUHua ,  SHENZhi-yong , JIFu

Department of General Surgery, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 201112, China;

Corresponding?author：

SHENZhi-yong, Email: doctorszy1970@163.com

Keywords：

Low molecular heparin; Anticoagulant; Inguinal hernia; Herniorrhaphy

DOI：

10.7507/1007-9424.20140337

Video：

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Objective To evaluate the safety and efficiency of perioperative low molecular heparin (LMH) as the replacement of anticoagulant for patients with inguinal hernia. Methods Sixty-three patients with oblique inguinal hernia from April 2009 to April 2012 in this hospital were analyzed retrospectively.Seventeen cases because of other diseases were long-term oral aspirin anticoagulant therapy (aspirin group), 11 cases because of other diseases were long-term oral warfarin anticoagulant therapy (warfarin group), anticoagulant therapy was replaced by continuing LMH 7 d before operation in the aspirin group and the warfarin group.The other 35 cases did not take any anticoagulant therapy (control group). Results ①The demography and preoperative international normalized ratio were similar among three groups (P > 0.05).②All the patients were followed-up.The duration of follow-up ranged from 12 months to 18 months.There were no statistical differences of the scrotal hematoma or subcutaneous hematoma, operation time, postoperative hospital stay, and VAS scoring among these three groups (P > 0.05).There was no recurrence in all the patients. Conclusion For a long term application of anticoagulant in patients with oblique inguinal hernia, perioperative application of LMH instead of anticoagulant does not increase the risk of bleeding, and could prevent thrombosis.

Citation： ZHANGJie, LIUHua, SHENZhi-yong, JIFu. Safety Assessment of Low Molecular Heparin Instead of Anticoagulant in Patients with Inguinal Hernia during Perioperative Period. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(11): 1417-1420. doi: 10.7507/1007-9424.20140337 Copy

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2.	Llau JV, Ferrandis R, Castillo J, et al.Recommendations on use of direct oral anticoagulants in the perioperative period[J].Med Clin (Barc), 2012, 139 Suppl 2:46-50.
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12.	胡大一, 張鶴萍, 孫藝紅, 等.華法林與阿司匹林預防非瓣膜性心房顫動患者血栓栓塞的隨機對照研究[J].中華心血管病雜志, 2006, 34(4):295-298.
13.	柴偉, 許猛, 張國強, 等.人工心臟瓣膜置換術后關節置換的圍手術期抗凝治療策略[J].中國骨與關節外科, 2013, 6(1):21-24.
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16.	Hirsh J, Warkentin TE, Shaughnessy SG, et al.Heparin and low-molecular-weight heparin:mechanisms of action, pharmacokinetics, dosing, monitoring, efficacy, and safety[J].Chest, 2001, 119(1 Suppl):64S-94S.
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19.	Suzuki S, Yamashita T, Kato T, et al.Incidence of major bleeding complication of warfarin therapy in Japanese patients with atrial fibrillation[J].Circ J, 2007, 71(5):761-765.
20.	孫藝紅, 胡大一.華法林對中國人心房顫動患者抗栓的安全性和有效性研究[J].中華內科雜志, 2004, 43(4):258-260.
21.	王寬, 王東, 鄭柳穎, 等.觀察ROC曲線用于評估非瓣膜心房顫動患者華法林抗凝出血風險[J].中國臨床藥理學雜志, 2013, 29(5):323-325.
22.	霍保善, 張武, 胡旭東, 等.氯諾昔康復合芬太尼用于心血管手術后患者自控靜脈鎮痛的臨床研究[J].中國醫藥指南, 2008, 6(15):4-6.
23.	王莉, 馮藝, 楊拔賢, 等.開胸手術后患者肋間神經冷凍鎮痛與硬膜外鎮痛對凝血功能的影響[J].中華麻醉學雜志, 2005, 25(10):725-728.

1. ?Pranavchand R, Reddy BM.Current status of understanding of the genetic etiology of coronary heart disease[J].J Postgrad Med, 2013, 59(1):30-41.
2. Llau JV, Ferrandis R, Castillo J, et al.Recommendations on use of direct oral anticoagulants in the perioperative period[J].Med Clin (Barc), 2012, 139 Suppl 2:46-50.
3. 唐健雄, 華蕾, 張逖, 等.成人腹股溝疝患病情況的多中心研究[J].外科理論與實踐, 2002, 7(6):421-423.
4. Pierides G, Mattila K, Vironen J.Quality of life change in elderly patients undergoing open inguinal hernia repair[J].Hernia, 2013, 17(6):729-736.
5. 張繁疆, 曾環洪, 藍錦文, 等.前入路腹膜前間隙無張力疝修補術治療成人腹股溝疝32例臨床分析[J/CD].中華疝和腹壁外科雜志:電子版, 2011, 5(3):320-324.
6. Lichtenstein IL, Shulman AG, Amid PK, et al.The tension-free hernioplasty[J].Am J Surg, 1989, 157(2):188-193.
7. 陳大偉, 史華俊, 劉開全, 等.引流在腹股溝無張力疝修補術中的應用[J/CD].中華疝和腹壁外科雜志:電子版, 2010, 4(1):40-43.
8. 蔡昭, 唐健雄, 黃磊, 等.經腹股溝切口單純腹膜前修補腹股溝疝的治療體會[J].外科理論與實踐, 2008, 13(6):531-533.
9. 靳根峰, 馮建超, 劉勇, 等.腹腔鏡與無張力疝修補治療復發性腹股溝疝對比分析[J/CD].中華疝和腹壁外科雜志:電子版, 2012, 6(4):61-63.
10. Krishna A, Misra MC, Bansal VK, et al.Laparoscopic inguinal hernia repair:transabdominal preperitoneal (TAPP) versus totally extraperitoneal (TEP) approach:a prospective randomized controlled trial.[J].Surg Endosc, 2012, 26(3):639-649.
11. 譚慧芬.阿司匹林用于中老年抗血栓最佳劑量分析[J].中國老年學雜志, 2013, 33(10):2393-2394.
12. 胡大一, 張鶴萍, 孫藝紅, 等.華法林與阿司匹林預防非瓣膜性心房顫動患者血栓栓塞的隨機對照研究[J].中華心血管病雜志, 2006, 34(4):295-298.
13. 柴偉, 許猛, 張國強, 等.人工心臟瓣膜置換術后關節置換的圍手術期抗凝治療策略[J].中國骨與關節外科, 2013, 6(1):21-24.
14. 王玨, 施萬印.抗凝、抗血小板及溶栓藥物的合理應用[J].介入放射學雜志, 2011, 20(1):76-81.
15. 夏錫儀, 譚玉林, 孫亞偉, 等.低分子肝素預防外科術后患者的肺栓塞[J].中國危重病急救醫學, 2011, 20(1):76-81.
16. Hirsh J, Warkentin TE, Shaughnessy SG, et al.Heparin and low-molecular-weight heparin:mechanisms of action, pharmacokinetics, dosing, monitoring, efficacy, and safety[J].Chest, 2001, 119(1 Suppl):64S-94S.
17. 陳紀林, 郭遠林.冠狀動脈介入治療中不同抗凝藥物的療效及安全性評述[J].中國循環雜志, 2011, 26(5):322-324.
18. Fuster V, Rydén LE, Cannom DS, et al.ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation:a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation):developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society[J].Circulation, 2006, 114(7):e257-e354.
19. Suzuki S, Yamashita T, Kato T, et al.Incidence of major bleeding complication of warfarin therapy in Japanese patients with atrial fibrillation[J].Circ J, 2007, 71(5):761-765.
20. 孫藝紅, 胡大一.華法林對中國人心房顫動患者抗栓的安全性和有效性研究[J].中華內科雜志, 2004, 43(4):258-260.
21. 王寬, 王東, 鄭柳穎, 等.觀察ROC曲線用于評估非瓣膜心房顫動患者華法林抗凝出血風險[J].中國臨床藥理學雜志, 2013, 29(5):323-325.
22. 霍保善, 張武, 胡旭東, 等.氯諾昔康復合芬太尼用于心血管手術后患者自控靜脈鎮痛的臨床研究[J].中國醫藥指南, 2008, 6(15):4-6.
23. 王莉, 馮藝, 楊拔賢, 等.開胸手術后患者肋間神經冷凍鎮痛與硬膜外鎮痛對凝血功能的影響[J].中華麻醉學雜志, 2005, 25(10):725-728.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Safety Assessment of Low Molecular Heparin Instead of Anticoagulant in Patients with Inguinal Hernia during Perioperative Period

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