抗凝对右心导管操作术后深静脉血栓发生的影响

发布时间：2018-04-21 16:12

本文选题：导管插入术 + 静脉血栓形成　；参考：《中国循环杂志》2017年08期

【摘要】：目的:探索右心导管操作术后深静脉血栓(DVT)的发生率及抗凝治疗的作用。方法:连续选择2015-01至2016-05行心内电生理检查(EPS)和(或)导管射频消融(RFCA)的患者171例,将在静脉系统可完成手术的室上性心动过速(室上速)患者随机分为抗凝组87例及非抗凝组84例。术后24~48 h行下肢血管多普勒彩超检查,比较二组间DVT发生率。结果:171例患者均为阵发性室上速患者,13例患者(抗凝组9例,非抗凝组4例)未完成术后下肢血管多普勒彩超检查而排除,共有158例患者完成术后检查及随访。抗凝组78例中有7例(8.97%)发生DVT;非抗凝组80例中有41例(51.3%)发生DVT,两组比较差异有统计学意义(P0.001)。48例发生DVT患者中有6例(12.5%)发生肌间静脉血栓,42例均为静脉穿刺点附近血栓。结论:右心导管操作术中未抗凝的患者DVT发生率较高,使用肝素抗凝可降低DVT发生率。
[Abstract]:Objective: to investigate the incidence and anticoagulant effect of DVT after right cardiac catheterization. Methods: 171 consecutive patients with intracardiac electrophysiologic examination (EPS) and / or radiofrequency catheter ablation (RFCA) were selected from January 2015 to May 2016-05. Patients with supraventricular tachycardia (supraventricular tachycardia) were randomly divided into anticoagulant group (n = 87) and non-anticoagulant group (n = 84). The incidence of DVT was compared between the two groups by color Doppler ultrasonography (CDFI) at 24 hours after operation. Results 171 patients were all patients with paroxysmal supraventricular tachycardia (9 patients in anticoagulant group and 4 patients in non-anticoagulant group). DVT occurred in 7 out of 78 patients in the anticoagulant group and in 41 out of 80 patients in the non-anticoagulant group. The difference between the two groups was statistically significant (P 0.001 / 48). Among the 48 patients with DVT, there were 6 patients with intramuscular venous thrombosis (12. 5%) and 42 cases with thrombus near the point of venipuncture. Conclusion: the incidence of DVT in patients without anticoagulation during right cardiac catheterization is higher. Heparin anticoagulation can reduce the incidence of DVT.
【作者单位】：云南省第一人民医院心内科;
【基金】：云南省科技厅重点项目(2014RA069)
【分类号】：R54

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