發(fā)布時間：2018-05-08 22:23

  本文選題：心房顫動 + 華法林�。� 參考：《中國現(xiàn)代醫(yī)學(xué)雜志》2017年16期

【摘要】：目的探討不同強度抗凝方案對心房顫動患者心臟起搏器植入術(shù)圍手術(shù)期出血和栓塞事件發(fā)生率的影響。方法選取2015年1月-2016年8月滁州市第一人民醫(yī)院心內(nèi)科住院的需要接受起搏器植入治療且長期服用華法林的房顫患者50例。根據(jù)術(shù)前抗凝強度,將患者隨機分為正常強度抗凝組25例和低強度抗凝組25例。觀察并比較兩組患者出血和栓塞事件的發(fā)生率與圍手術(shù)期抗凝強度的關(guān)系。結(jié)果正�？鼓龔姸冉M出現(xiàn)2例(8%)切口滲血,1例(4%)囊袋血腫,共3例(12%)出血并發(fā)癥;低強度抗凝組出現(xiàn)1例(4%)切口滲血,1例(4%)囊袋血腫,共2例(8%)出血并發(fā)癥。兩組間出血并發(fā)癥比較差異無統(tǒng)計學(xué)意義(P0.05),兩組間切口滲血并發(fā)癥比較差異無統(tǒng)計學(xué)意義(P0.05),兩組間囊袋血腫并發(fā)癥比較差異無統(tǒng)計學(xué)意義(P0.05)。兩組患者圍手術(shù)期內(nèi),均無栓塞事件發(fā)生。結(jié)論對于需要植入起搏器的口服華法林的心房顫動患者,術(shù)前正常強度抗凝治療不會增加起搏器植入圍手術(shù)期出血事件的發(fā)生率,低強度抗凝不增加圍手術(shù)期血栓栓塞風(fēng)險。
[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.
【作者單位】： 安徽醫(yī)科大學(xué)滁州臨床學(xué)院(滁州市第一人民醫(yī)院);
【分類號】：R541.75

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