本文選題：射頻消融術(shù)　切入點：靜脈血栓形成　出處：《新疆醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的:探討射頻消融術(shù)對股靜脈血栓形成的影響及利伐沙班的防治效果。方法:176例行RFCA患者隨機分為兩組,治療組86例術(shù)后2-3h開始口服利伐沙班10mg/d至14d,對照組90例術(shù)后2-3h口服阿司匹林100mg/d,至術(shù)后3個月,不應(yīng)用利伐沙班。兩組患者再按左、右心導(dǎo)管操作各成為兩個亞組。分別于術(shù)前、術(shù)后48-72h,術(shù)后14天進行3次隨訪,記錄死亡、胸痛、下肢腫脹等臨床事件;行雙下肢彩色多普勒超聲結(jié)果觀察靜脈血栓形成及血管內(nèi)徑、頻譜血流速度的變化情況。并對臨床資料:年齡、性別、空腹血糖、餐后2小時血糖、糖化血紅蛋白、膽固醇、高密度脂蛋白、低密度脂蛋白、甘油三脂、凝血時間、纖維蛋白原、D-二聚體,合并冠心病、高血壓、糖尿病、靜脈瓣膜功能不全、伴有吸煙等17項指標進行單因素分析,將有統(tǒng)計學(xué)意義的危險因素進行多因素logistic回歸分析。結(jié)果:治療組86例病人93根靜脈,48-72h內(nèi)復(fù)查多普勒彩色超聲檢查,非閉塞性血栓發(fā)生率5.8%;對照組90例病人95根靜脈,非閉塞性DVT發(fā)生率16.7%;兩組治療期間均無完全閉塞性血栓形成;2例股靜脈血腫事件,均與研究藥物無關(guān),未發(fā)生出血事件。治療組、對照組兩亞組:左心導(dǎo)管操作股靜脈血栓發(fā)生率高于右心導(dǎo)管操作者。膽固醇增高、凝血時間縮短和糖尿病患者是RFCA術(shù)后DVT形成的獨立危險因素。結(jié)論:射頻消融術(shù)后應(yīng)用利伐沙班預(yù)防股靜脈血栓安全、有效。膽固醇增高、凝血時間縮短和糖尿病患者是RFCA術(shù)后DVT形成的獨立危險因素,因此在RFCA術(shù)前對DVT高危患者予以重視,避免不良血栓事件的發(fā)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.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R541.7

【參考文獻】

相關(guān)期刊論文 前10條

1 吳再濤;李玲;單其俊;;射頻消融術(shù)對凝血功能的影響及肝素的干預(yù)作用[J];中國循環(huán)雜志;2013年01期

2 李學(xué)文;;心律失常的射頻消融治療[J];實用醫(yī)技雜志;2010年07期

3 付華;胡宏德;楊慶;崔凱軍;初寧;姜建;;4865例陣發(fā)性室上性心動過速導(dǎo)管消融治療回顧分析[J];生物醫(yī)學(xué)工程學(xué)雜志;2009年03期

4 王勇;劉曉飛;李憲倫;曾玉杰;高炎莎;趙霞;趙桂茹;柯元南;;射頻消融術(shù)后并發(fā)深靜脈血栓原因分析及處理[J];中國心臟起搏與心電生理雜志;2006年02期

5 周忠江,黃曉波,賈滿盈;射頻消融術(shù)后肺栓塞一例[J];中華心血管病雜志;2004年11期

6 張勁林,王方正,張奎俊,馬堅,姚焰,楚建民,方丕華,張澍;九例射頻消融術(shù)導(dǎo)致的血栓栓塞并發(fā)癥[J];中國心臟起搏與心電生理雜志;2004年04期

7 ;射頻導(dǎo)管消融治療快速心律失常指南(修訂版)[J];中國心臟起搏與心電生理雜志;2002年02期

8 鄧學(xué)東,沈延政,ROTTO;彩色多普勒超聲在下肢深靜脈血栓形成診斷中的價值[J];中國醫(yī)學(xué)影像技術(shù);2000年08期

9 楊新春,胡大一,商麗華,劉曉惠,王樂豐,崔亮,頊志敏;射頻消融術(shù)后肺栓塞一例[J];中國心臟起搏與心電生理雜志;1998年01期

10 曾秋棠,張彥周,于世龍,陳志堅,張家明;射頻消融對血小板活性的影響[J];臨床心血管病雜志;1997年05期

，

本文編號：1696572