摘要
目的探讨瓣膜置换术后长期使用华法林治疗的患者起搏器植入围手术期恰当的抗凝方式。方法回顾性分析本院住院的瓣膜置换术后长期华法林治疗过程中需要植入器械的患者,根据围手术期抗凝方式的不同分为停用组、桥接组和继续组,分析不同抗凝方式与出血和栓塞事件风险的关系。结果共入选132例,3组年龄、性别、伴发疾病、是否心房颤动及是否为更换起搏器方面均无差异。瓣膜手术方式及起搏器类型存在差异。3组血肿发生无差异(P=0.125),伤口渗血在桥接组明显多(P=0.008)。三组均未出现栓塞。结论瓣膜置换术后长期使用华法林治疗的患者起搏器植入围手术期继续使用华法林比应用低分子肝素的桥接治疗伤口血肿和渗血风险小。
Objective To analyze the choice of perioperative anticoagulation for patients of long-term warfalin therapy after valve replacement during device implantation. Methods Patients who wanted to implant pacemakers with long-term warfalin therapy after valve replacement admitted to our hospital were enrolled in the study prospectively. The patients were divided into 3 groups according to the perioperative anticoagulation methods： stopped group, bridging group and continued group. Analysis of the relationship of different perioperative anticoagulation methods with the hemorrhage and embolism events. Results One hundred and thirty-two patients were enrolled. There was no significant difference in age, sex, concomitant diseases, atrial fibrillation and needing replacement among 3 groups. The occurrence of haematomas had no significant difference among the 3 groups （P = 0. 125 ）. More patients in the bridging group had oozing of blood （P = 0. 008）. There were no thromboembolic event in all the three groups. Conclusion There are less haematomas and wound oozing of blood in bridging group than in continued group for patients who wanted to implant pacemakers with long-term warfalin therapy after valve replacement.
出处
《中国心脏起搏与心电生理杂志》
2012年第5期397-399,共3页
Chinese Journal of Cardiac Pacing and Electrophysiology
基金
北京市卫生系统高层次卫生技术人才培养计划资助(项目编号:2009-3-48)
关键词
心血管病学
起搏器
抗凝
瓣膜置换术
血肿
血栓栓塞
Cardiology
Pacemaker
Anticoagulation
Valve replacement
Haematomas
Thromboembolism
