达比加群、华法林分别用于心房颤动患者射频消融术后疗效与安全性的比较

发布时间：2018-07-12 15:48

  本文选题：心房颤动 + 射频消融术　； 参考：《中国药房》2017年09期

【摘要】：目的:比较达比加群、华法林用于心房颤动患者射频消融术(RFCA)后的疗效和安全性。方法:回顾性分析141例非瓣膜性心房颤动并拟行RFCA患者资料,按用药的不同分为华法林组(71例)和达比加群组(70例)。华法林组患者入院前曾服华法林者入院后需停用,改为低分子肝素钙注射液100 U/kg,皮下注射,待INR1.5时行RFCA,术前12 h停用低分子肝素钙注射液;术中静脉注射肝素钙注射液100 U/kg;术后4~6 h口服华法林钠片4.5 mg,每日1次,同时与低分子肝素桥接重叠治疗至少3~5 d;术后每3 d监测1次国际标准化比值(INR),维持INR 2.0~3.0,至少服用华法林3个月。达比加群组患者入院后停用曾服用的抗凝药物,改为口服达比加群酯胶囊110 mg(年龄≥70岁或体质量60 kg)或150 mg(年龄70岁或体质量≥60 kg),每日2次;术前24 h停用达比加群酯胶囊,术中用药同华法林组;术后6 h口服达比加群酯胶囊,至少服用3个月。观察两组患者术后第1、3个月总死亡率、脑卒中(短暂性脑缺血,缺血性脑病)发生率、外周血管栓塞率及出血情况。结果:两组患者术后第1、3个月总死亡率、脑卒中发生率、外周血管栓塞率、出血发生率比较,差异均无统计学意义(P0.05)。结论:达比加群用于非瓣膜性心房颤动患者RFCA的抗凝疗效和安全性均与华法林相当。
[Abstract]:Objective: to compare the efficacy and safety of warfarin in radiofrequency ablation (RFCA) in patients with atrial fibrillation. Methods: 141 patients with non-valvular atrial fibrillation and RFCA were retrospectively analyzed and divided into warfarin group (71 cases) and Darbiga group (70 cases). The patients in warfarin group who had taken warfarin before admission had to stop taking warfarin after admission. They were injected subcutaneously with low-molecular-weight heparin calcium injection (100U / kg). RFCA was performed at INR 1.5, and the low-molecular-weight heparin calcium injection was stopped 12 hours before operation. Intraoperative intravenous injection of heparin calcium 100 U / kg, oral administration of warfarin sodium tablet 4.5 mg at 4 h after operation, once a day, At the same time, the overlap therapy with low molecular weight heparin (LMWH) was performed for at least 3 to 5 days, and the international standardized ratio (INR) was monitored once every 3 days after operation to maintain INR 2.0 ~ 3.0, and to take warfarin for at least 3 months. After admission, the group of Darbiga patients stopped taking anticoagulant drugs and were given orally Dapicarbate capsule 110mg (age 鈮，

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