口服华法林的心房颤动患者起搏器植入围手术期不同抗凝方案的比较

发布时间：2018-05-08 22:23

本文选题：心房颤动 + 华法林　；参考：《中国现代医学杂志》2017年16期

【摘要】：目的探讨不同强度抗凝方案对心房颤动患者心脏起搏器植入术围手术期出血和栓塞事件发生率的影响。方法选取2015年1月-2016年8月滁州市第一人民医院心内科住院的需要接受起搏器植入治疗且长期服用华法林的房颤患者50例。根据术前抗凝强度,将患者随机分为正常强度抗凝组25例和低强度抗凝组25例。观察并比较两组患者出血和栓塞事件的发生率与围手术期抗凝强度的关系。结果正常抗凝强度组出现2例(8%)切口渗血,1例(4%)囊袋血肿,共3例(12%)出血并发症;低强度抗凝组出现1例(4%)切口渗血,1例(4%)囊袋血肿,共2例(8%)出血并发症。两组间出血并发症比较差异无统计学意义(P0.05),两组间切口渗血并发症比较差异无统计学意义(P0.05),两组间囊袋血肿并发症比较差异无统计学意义(P0.05)。两组患者围手术期内,均无栓塞事件发生。结论对于需要植入起搏器的口服华法林的心房颤动患者,术前正常强度抗凝治疗不会增加起搏器植入围手术期出血事件的发生率,低强度抗凝不增加围手术期血栓栓塞风险。
[Abstract]:Objective to investigate the effect of different anticoagulant regimens on the incidence of perioperative hemorrhage and embolism in patients with atrial fibrillation after pacemaker implantation. Methods from January 2015 to August 2016, 50 patients with atrial fibrillation who were hospitalized in Department of Cardiology, the first people's Hospital of Chuzhou, were treated with pacemaker implantation and took warfarin for a long time. According to the preoperative anticoagulant strength, the patients were randomly divided into normal intensity anticoagulant group (25 cases) and low intensity anticoagulant group (25 cases). The relationship between the incidence of hemorrhage and embolism and the perioperative anticoagulant intensity was observed and compared between the two groups. Results in the normal anticoagulant strength group, there were 2 cases (8%) incision blood leakage and 4 cases) bag hematoma, 3 cases (12 cases) hemorrhage complication, and 1 case of low intensity anticoagulant group (1 case) and 1 case (4 cases) of hemoperfusion through incision) bag hematoma, 2 cases (8 cases) bleeding complication. There was no significant difference in complications of bleeding between the two groups (P 0.05), and there was no significant difference in complications of incision bleeding between the two groups (P 0.05). There was no significant difference in complications between the two groups (P 0.05), and there was no significant difference in complications between the two groups (P 0.05). No embolism occurred in both groups during the perioperative period. Conclusion for patients with atrial fibrillation who need pacemaker implantation, normal anticoagulant therapy does not increase the incidence of perioperative bleeding and low intensity anticoagulation does not increase the perioperative risk of thromboembolism.
【作者单位】：安徽医科大学滁州临床学院(滁州市第一人民医院);
【分类号】：R541.75

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