机械瓣膜置换术后华法林抗凝致出血并发症的影响因素分析

发布时间：2019-07-25 19:50

【摘要】：目的分析机械瓣膜置换术后华法林抗凝致出血并发症的影响因素。方法选取我院2014年10月~2015年10月收治的132例机械瓣膜置换术后以华法林抗凝的患者为研究对象,按有无出血并发症分为观察组(57例)和对照组(75例)。回顾性分析所有研究对象的病案资料,包括性别、年龄、病程、瓣膜置换数量、文化程度、主动脉阻断时间、体外循环时间、血压、家庭收入、抽烟史、饮酒史、合并疾病、抗凝认知程度及依从性等,单因素及多因素Logistic回归分析。结果较对照组,观察组女性、病程5年、文化程度大专以下、吸烟史、有合并疾病、抗凝认知程度差、抗凝依从性差者占比68.42%、61.40%、77.19%、54.39%、50.88%、78.95%、73.68%高,上述指标两组比较差异均有统计学意义(P0.05);多因素Logistic回归分析结果显示,学历大专以下、抗凝认知差、抗凝治疗依从性差与机械瓣膜置换术后华法林抗凝致出血并发症发生有显著相关性,OR值分别为2.856、3.138和3.656。结论病程5年、抗凝认知差、治疗依从性差均为机械瓣膜置换术后华法林抗凝致出血并发症的主要影响因素。
[Abstract]:Objective to analyze the influencing factors of warfarin anticoagulant bleeding complications after mechanical valve replacement. Methods 132 patients with warfarin anticoagulant after mechanical valve replacement from October 2014 to October 2015 were divided into observation group (57 cases) and control group (75 cases) according to the complications of bleeding. The data of medical records, including sex, age, course of disease, number of valve replacement, educational level, aortic occlusion time, cardiopulmonary bypass time, blood pressure, family income, smoking history, drinking history, complicated disease, anticoagulant cognitive degree and compliance, were analyzed retrospectively. univariate and multivariate Logistic regression analysis was used to analyze the number of valve replacement, aortic occlusion time, cardiopulmonary bypass time, blood pressure, family income, smoking history, drinking history, combined disease, anticoagulant cognition and compliance. Results compared with the control group, the female in the observation group had a course of 5 years, less than college education, smoking history, complicated diseases, poor anticoagulant cognition, poor anticoagulant compliance accounted for 68.42%, 61.40%, 77.19%, 54.39%, 50.88%, 78.95%, 73.68%. There was significant difference between the two groups (P 0.05). The results of multivariate Logistic regression analysis showed that the results of multivariate Logistic regression analysis showed that there was a significant correlation between the compliance of anticoagulant therapy and the complications of warfarin anticoagulant bleeding after mechanical valve replacement, the OR values were 2.856, 3.138 and 3.656, respectively. Conclusion the course of disease for 5 years, poor anticoagulant cognition and poor treatment compliance are the main influencing factors of warfarin anticoagulant bleeding complications after mechanical valve replacement.
【作者单位】：湖北医药学院附属襄阳医院(湖北省襄阳市第一人民医院)心血管内科;
【分类号】：R654.2

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