射频消融对深静脉血栓形成的影响及利伐沙班的防治效果

发布时间：2018-04-01 17:23

本文选题：射频消融术　切入点：静脉血栓形成　出处：《新疆医科大学》2015年硕士论文

【摘要】：目的:探讨射频消融术对股静脉血栓形成的影响及利伐沙班的防治效果。方法:176例行RFCA患者随机分为两组,治疗组86例术后2-3h开始口服利伐沙班10mg/d至14d,对照组90例术后2-3h口服阿司匹林100mg/d,至术后3个月,不应用利伐沙班。两组患者再按左、右心导管操作各成为两个亚组。分别于术前、术后48-72h,术后14天进行3次随访,记录死亡、胸痛、下肢肿胀等临床事件;行双下肢彩色多普勒超声结果观察静脉血栓形成及血管内径、频谱血流速度的变化情况。并对临床资料:年龄、性别、空腹血糖、餐后2小时血糖、糖化血红蛋白、胆固醇、高密度脂蛋白、低密度脂蛋白、甘油三脂、凝血时间、纤维蛋白原、D-二聚体,合并冠心病、高血压、糖尿病、静脉瓣膜功能不全、伴有吸烟等17项指标进行单因素分析,将有统计学意义的危险因素进行多因素logistic回归分析。结果:治疗组86例病人93根静脉,48-72h内复查多普勒彩色超声检查,非闭塞性血栓发生率5.8%;对照组90例病人95根静脉,非闭塞性DVT发生率16.7%;两组治疗期间均无完全闭塞性血栓形成;2例股静脉血肿事件,均与研究药物无关,未发生出血事件。治疗组、对照组两亚组:左心导管操作股静脉血栓发生率高于右心导管操作者。胆固醇增高、凝血时间缩短和糖尿病患者是RFCA术后DVT形成的独立危险因素。结论:射频消融术后应用利伐沙班预防股静脉血栓安全、有效。胆固醇增高、凝血时间缩短和糖尿病患者是RFCA术后DVT形成的独立危险因素,因此在RFCA术前对DVT高危患者予以重视,避免不良血栓事件的发生。
[Abstract]:Objective: to investigate the effect of radiofrequency ablation on femoral vein thrombosis and the prevention and treatment of Levasaban.Methods Twenty 176 patients with RFCA were randomly divided into two groups. 86 patients in the treatment group took livasapan 10mg/d to 14 days from 2 to 3 hours after operation, and 90 patients in the control group were given aspirin 100 mg / d at 2 to 3 hours after operation until 3 months after operation.Two groups were operated by left and right cardiac catheterization respectively.The clinical events such as death chest pain and lower extremity swelling were recorded before operation 48-72 hours after operation and 14 days after operation. The changes of venous thrombosis blood vessel diameter and frequency spectrum blood flow velocity were observed by color Doppler ultrasound of both lower extremities.The clinical data were as follows: age, sex, fasting blood glucose, 2 hours postprandial blood glucose, glycosylated hemoglobin, cholesterol, high density lipoprotein, low density lipoprotein, triglyceride, coagulation time, fibrinogen D-dimer, coronary heart disease.17 indexes of hypertension, diabetes, venous valve insufficiency and smoking were analyzed by univariate analysis. Multivariate logistic regression analysis was performed on the statistically significant risk factors.Results: in 86 patients in the treatment group, the incidence of non-occlusive thrombus was 5.8%, and 95 veins in 90 patients in the control group were examined by color Doppler ultrasound within 48 to 72 hours.The incidence of non-occlusive DVT was 16.7.The two cases of femoral vein hematoma were not found in the two groups during the treatment period, which had nothing to do with the drugs studied and no bleeding.In treatment group and control group, the incidence of femoral vein thrombosis by left cardiac catheterization was higher than that by right cardiac catheterization.Increased cholesterol, shorter coagulation time and diabetes were independent risk factors for DVT after RFCA.Conclusion: after radiofrequency ablation, rivastaban is safe and effective in preventing femoral vein thrombosis.High cholesterol, shorter coagulation time and diabetes are independent risk factors for the formation of DVT after RFCA. Therefore, attention should be paid to high risk patients with DVT before RFCA to avoid adverse thrombotic events.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R541.7

【参考文献】