中华老年多器官疾病杂志
中華老年多器官疾病雜誌
중화노년다기관질병잡지
CHINESE JOURNAL OF MULTIPLE ORGAN DISEASES IN THE ELDERLY
2013年
10期
733-735
,共3页
王磊%刘润梅%翟红霞%李良%殷亚昕%张津津%陈海威%李娜%赵志坤%曹佳%谷沫丽%夏云峰
王磊%劉潤梅%翟紅霞%李良%慇亞昕%張津津%陳海威%李娜%趙誌坤%曹佳%穀沫麗%夏雲峰
왕뢰%류윤매%적홍하%리량%은아흔%장진진%진해위%리나%조지곤%조가%곡말려%하운봉
老年人%冠心病%肾功能不全%介入治疗%依诺肝素
老年人%冠心病%腎功能不全%介入治療%依諾肝素
노년인%관심병%신공능불전%개입치료%의낙간소
aged%coronary heart disease%renal insufficiency%interventional therapy%enoxaparin
目的：探讨不同剂量依诺肝素抗凝在老年冠心病合并肾功能不全患者介入治疗围术期的安全有效剂量。方法分析2009年1月至2012年12月在我科住院的108例冠心病合并肾功能不全介入治疗围术期应用依诺肝素的患者，按依诺肝素应用剂量共分为3组。A组（n＝31）：依诺肝素40mg，皮下注射，每12小时1次。B组（n＝35）：依诺肝素40mg，皮下注射，每日1次。C组（n＝42）：依诺肝素40mg，皮下注射，每早1次以及依诺肝素20mg，皮下注射，每晚1次。观察各组出血及支架内血栓发生率。结果在服用同样剂量阿司匹林和氯吡格雷的情况下，3组患者均无大出血及支架内血栓发生，但A组患者皮下出血、牙龈出血发生率明显高于其他两组。结论老年冠心病合并肾功能不全患者介入治疗围术期给予依诺肝素，40mg皮下注射，每早1次，20mg皮下注射，每晚1次，共5～7d，是安全和有效的。
目的：探討不同劑量依諾肝素抗凝在老年冠心病閤併腎功能不全患者介入治療圍術期的安全有效劑量。方法分析2009年1月至2012年12月在我科住院的108例冠心病閤併腎功能不全介入治療圍術期應用依諾肝素的患者，按依諾肝素應用劑量共分為3組。A組（n＝31）：依諾肝素40mg，皮下註射，每12小時1次。B組（n＝35）：依諾肝素40mg，皮下註射，每日1次。C組（n＝42）：依諾肝素40mg，皮下註射，每早1次以及依諾肝素20mg，皮下註射，每晚1次。觀察各組齣血及支架內血栓髮生率。結果在服用同樣劑量阿司匹林和氯吡格雷的情況下，3組患者均無大齣血及支架內血栓髮生，但A組患者皮下齣血、牙齦齣血髮生率明顯高于其他兩組。結論老年冠心病閤併腎功能不全患者介入治療圍術期給予依諾肝素，40mg皮下註射，每早1次，20mg皮下註射，每晚1次，共5～7d，是安全和有效的。
목적：탐토불동제량의낙간소항응재노년관심병합병신공능불전환자개입치료위술기적안전유효제량。방법분석2009년1월지2012년12월재아과주원적108례관심병합병신공능불전개입치료위술기응용의낙간소적환자，안의낙간소응용제량공분위3조。A조（n＝31）：의낙간소40mg，피하주사，매12소시1차。B조（n＝35）：의낙간소40mg，피하주사，매일1차。C조（n＝42）：의낙간소40mg，피하주사，매조1차이급의낙간소20mg，피하주사，매만1차。관찰각조출혈급지가내혈전발생솔。결과재복용동양제량아사필림화록필격뢰적정황하，3조환자균무대출혈급지가내혈전발생，단A조환자피하출혈、아간출혈발생솔명현고우기타량조。결론노년관심병합병신공능불전환자개입치료위술기급여의낙간소，40mg피하주사，매조1차，20mg피하주사，매만1차，공5～7d，시안전화유효적。
Objective To investigate the safe and effective dosage of enoxaparin in the elderly patients with coronary heart disease and renal insufficiency during interventional operation. Methods A total of 108 senile patients with above 2 disorders who received interventional treatment and perioperative enoxaparin for anticoagulation in our department from January 2009 to December 2012 were recruited in this study. They were divided into 3 groups according to the dose of enoxaparin, that is, group A (n=31, 40mg enoxaparin, subcutaneous injection, once every 12 hour), group B (n=35, 40mg enoxaparin, subcutaneous injection , once a day), and group C (n=42, 40mg enoxaparin, subcutaneous injection, once every morning, and 20mg once every night). They all took the same doses of aspirin and clopidogrel. The bleeding and stent thrombosis rate were observed and compared among the 3 groups. Results No massive hemorrhage or stent thrombosis was found in the 3 groups. But the patients from group A had significantly higher prevalence of subcutaneous hemorrhage and gum bleeding than those from the other 2 groups. Conclusion It is quite safe and effective for the elderly coronary heart disease patients accompanied with renal insufficiency to be given 40mg enoxaparin, subcutaneous injection, once every morning, and 20mg once every night, for a total of 5 to 7d during interventional therapy.
