Treatment of long-term oral aspirin patients combined with craniocerebral injury / 中华创伤杂志

ABSTRACT

Objective To investigate the clinical characteristics and treatments of patients with long-term oral aspirin treatment combined with craniocerebral injury.Methods A retrospective analysis was made on 24 cases admitted for long-term oral aspirin treatment combined with craniocerebral injury from January 2010 to June 2012.There were 15 males and 9 females at age of 52-78 years (mean,63.5years).Injuries were caused by a traffic accident in 18 cases,a high fall in four and a blow in two.GCS on admission was 13-15 points in six cases,10-12 points in 10 cases and ＜ 8 points in eight cases.Six cases had conventional treatment,nine puncture drainage,six intracerebral hematoma evacuation by small craniotomy and three hematoma evacuation by large craniotomy.Results The patients were followed up for three months.Glasgow outcome score (GOS) was used to assess the prognosis in five categories,i.e.,grade Ⅴ (good recovery),grade Ⅳ (low disability),grade Ⅲ (severe disability),grade Ⅱ (vegetative state) and grade Ⅰ (death).Besides,grades Ⅴ and Ⅳ GOS represented a good outcome.Of these patients 15 (62.5％) had good results and nine (37.5 ％) undesirable results.Conclusions Patients with long-term oral aspirin administration combined with craniocerebral injury are characterized by high incidence of delayed and progressive cerebral hemorrhage,multi-focus intracerebral hemorrhage and postoperative rehemorrhagia.Therefore,aspirin therapy should be discontinued.Instead,enough blood coagulation accelerator,platelet and fresh plasma should be given.An operation is necessary for the patients with critically severe conditions but is not advisable for the patients with milder conditions.