摘要
目的观察射频消融术与冷冻消融术对心律失常患者凝血参数及血小板功能的影响。方法选取2016年11月至2017年10月我院收治的86例房颤病例,按照手术方式差异分为射频消融组(n=43)与冷冻消融组(n=43),比较2组手术前后凝血参数、血小板功能,并观察2组血栓发生情况。结果术后即刻,2组a PTT明显缩短,血浆D-D、v WF明显升高(P <0.05),射频消融组缩短与升高程度更显著(P <0.05);术后24h,2组a PTT明显延长,血浆D-D、v WF明显降低(P <0.05),冷冻消融组与术前比较无明显差异(P> 0.05);术后即刻,2组GMP-140、血小板膜CD62P、CD63、血小板聚集率均明显升高(P <0.05),射频消融组升高程度更显著(P <0.05);术后24h,2组GMP-140、血小板膜CD62P、CD63、血小板聚集率明显降低(P <0.05),冷冻消融组与术前比较无明显差异(P> 0.05);冷冻消融组血栓总发生率2.33%,明显低于射频消融组13.95%(P <0.05)。结论相较于射频消融术,冷冻消融术可减少对房颤患者凝血指标与血小板功能的影响,降低血栓栓塞风险。
Objective To observe the effect of radiofrequency ablation and cryoablafion on blood coagulation parameters and platelet function in patients with Atrial fibrillation.Methods 86patients with arrhythmia who were admitted to our hospital from February 2015to March 2017were selected and divided into radiofrequency ablation group (n=43)and cryoablation group (n=43)according to different operative methods.The blood coagulation parameters and platelet function were compared between the 2groups before and after the operation,and the occurrence of thrombus in the 2groups was observed.Results The aPTT in the two groups was obviously shortened,and plasma D-D and vWF were significantly increased immediately after the operation (P <0.05 ),and changes in the radiofrequency ablation group were more significant (P < 0.05).The aPTT in the 2groups was prolonged significantly,and plasma D-D and vWF were decreased significantly in 24h after operation(P <0.05 ),changes in the cryoablafion group was no significant difference compared with those before operation (P >0.05 ).GMP-140,platelet membrane CD62P,CD63and platelet aggregation rates in the 2groups were increased significantly immediately after operation (P <0.05 ),and the increase in radiofrequency ablation group was more obvious (P <0.05 ).In 24h after operation,GMP-140, platelet membrane CD62P,CD63and platelet aggregation rates in the 2groups were decreased significantly(P <0.05 ),the decrease in the cryoablation group was no significant difference compared with those before operation (P >0.05 ).The total incidence of thrombus in the cryoablation group was significantly lower than that in the radiofrequency ablation group (2.33%vs 13.95%)(P <0.05 ).Conclusion Compared with radiofrequency ablation,cryoablation can reduce the effect on coagulation parameters and platelet function in patients with Atrial fibrillation,and reduce the risk of thromboembolism.
作者
李森军
张敏霞
李同斌
LI Sen-jun;ZHANG Min-xia;LI Tong-bin(Internal hvo families,High and new hospital Xi 'an Cit,Xi 'an,710000,China;Department of Internal Medicine- Cardiovascular,Air Force Medical University of Xijing Hospital,Xi'an,710000,China)
出处
《血栓与止血学》
2018年第6期957-960,共4页
Chinese Journal of Thrombosis and Hemostasis
关键词
射频消融术
冷冻消融术
房颤
凝血参数
血小板功能
Radiofrequency ablation
Cryoablation
Atrial fibrillation
Coagulation parameters
Platelet function
