目的 系統(tǒng)評價阿司匹林預(yù)防骨科大手術(shù)后靜脈血栓栓塞癥的有效性及安全性。方法 檢索PubMed，Embase和Cochrane圖書館，收集阿司匹林預(yù)防圍手術(shù)期靜脈血栓栓塞癥的隨機對照研究（RCT）及隊列研究，提取資料并評價質(zhì)量后，采用RevMan 5.3軟件進行Meta分析。結(jié)果 共納入7項RCT和5項回顧性隊列研究。與空白對照組相比，阿司匹林能降低術(shù)后深靜脈血栓形成率[RR=0.69，95%CI（0.54，0.89），P=0.004]及肺栓塞發(fā)生率[RR=0.60，95%CI（0.43，0.84），P=0.003]。與低分子肝素□LMWH□相比，阿司匹林的術(shù)后深靜脈血栓形成率、肺栓塞發(fā)生率、血紅蛋白下降量分別為[RR=1.06，95%CI（0.96，1.17），P=0.22]，[RR=1.04，95%CI（0.93，1.18），P=0.48]以及[MD=-7.61，95%CI（-11.73，-3.49），P=0.000 3]。結(jié)論 與空白對照組相比，阿司匹林能降低骨科大手術(shù)后靜脈血栓栓塞癥的發(fā)生率；與LMWH相比，在術(shù)后靜脈血栓栓塞癥發(fā)生率方面沒有差異，血紅蛋白下降量低于LMWH；阿司匹林與空白對照、LMWH的其他并發(fā)癥比較沒有差異。

Objective To systematically review the efficacy and safety of aspirin for preventing venous thromboembolism (VTE) after major orthopedic surgery. Methods Retrieved from PubMed, Embase and Cochrane Library, randomized controlled trials (RCT) and cohort studies about aspirin used in major orthopedic surgery were collected. Meta-analysis was performed by using Rev Man 5.3 software after data extraction and quality evaluation. Results Totally seven RCTs and five cohort studies were included. Compared with control group, aspirin reduced the incidence of deep vein thrombosis (DVT)[RR=0.69, 95%CI(0.54, 0.89), P=0.004] and pulmonary embolism(PE)[RR=0.60, 95%CI(0.43, 0.84), P=0.003]. Compared with low molecular weight heparin (LMWH), the incidence of DVT, PE and hemoglobin drop were[RR=1.06, 95%CI(0.96, 1.17), P=0.22],[RR=1.04, 95%CI(0.93, 1.18), P=0.48] and[MD=-7.61, 95%CI(-11.73, -3.49), P=0.000 3] respectively in aspirin group. Conclusions Compared with control, aspirin could reduce VTE incidence after major orthopedic surgery. There were no significant differences in VTE incidence between aspirin and LMWH, but hemoglobin drop were lower in aspirin group. For other complications, there were no significant differences between aspirin and control/LMWH.