国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2013年
1期
71-74
,共4页
主动脉球囊反搏术%普通肝素%低分子肝素%疗效
主動脈毬囊反搏術%普通肝素%低分子肝素%療效
주동맥구낭반박술%보통간소%저분자간소%료효
Aortic balloon pump surgery%Unfractionated heparin%Low-molecular-weight heparin%Efficacy
目的 观察主动脉反搏术中使用普通肝素与低分子肝素的疗效差异.方法 将28例在主动脉球囊反搏术中使用低分子肝素的患者作为观察组,将30例在主动脉球囊反搏术中使用低分子肝素的患者作为对照组,比较两组患者的疗效差异.结果 两组患者的即刻病情改善率(67.86％vs56.67％)及30 d内病死率(10.71％vs16.67％)等指标无统计学差异(P＞0.05),但是观察组的出血、血肿等的并发症发生率(7.14％)明显低于对照组(30％),其相对风险比为4.200.而两组的球囊管中心堵塞、下肢动脉缺血等的发生率无统计学差异(3.57％vs 16.67％).对照组的平均血小板计数[(158.5±82.9)×109/L]低于观察组[(231.3±45.2)×109/L].结论 在主动脉球囊反搏术中,与普通肝素比较,采用低分子肝素虽然对病情改善及病死率的影响无明显差异,但可以显著改善各类出血并发症,并且对血小板的影响更小,推荐在主动脉球囊反搏术中使用低分子肝素替代普通肝素作为抗凝剂.
目的 觀察主動脈反搏術中使用普通肝素與低分子肝素的療效差異.方法 將28例在主動脈毬囊反搏術中使用低分子肝素的患者作為觀察組,將30例在主動脈毬囊反搏術中使用低分子肝素的患者作為對照組,比較兩組患者的療效差異.結果 兩組患者的即刻病情改善率(67.86％vs56.67％)及30 d內病死率(10.71％vs16.67％)等指標無統計學差異(P＞0.05),但是觀察組的齣血、血腫等的併髮癥髮生率(7.14％)明顯低于對照組(30％),其相對風險比為4.200.而兩組的毬囊管中心堵塞、下肢動脈缺血等的髮生率無統計學差異(3.57％vs 16.67％).對照組的平均血小闆計數[(158.5±82.9)×109/L]低于觀察組[(231.3±45.2)×109/L].結論 在主動脈毬囊反搏術中,與普通肝素比較,採用低分子肝素雖然對病情改善及病死率的影響無明顯差異,但可以顯著改善各類齣血併髮癥,併且對血小闆的影響更小,推薦在主動脈毬囊反搏術中使用低分子肝素替代普通肝素作為抗凝劑.
목적 관찰주동맥반박술중사용보통간소여저분자간소적료효차이.방법 장28례재주동맥구낭반박술중사용저분자간소적환자작위관찰조,장30례재주동맥구낭반박술중사용저분자간소적환자작위대조조,비교량조환자적료효차이.결과 량조환자적즉각병정개선솔(67.86％vs56.67％)급30 d내병사솔(10.71％vs16.67％)등지표무통계학차이(P＞0.05),단시관찰조적출혈、혈종등적병발증발생솔(7.14％)명현저우대조조(30％),기상대풍험비위4.200.이량조적구낭관중심도새、하지동맥결혈등적발생솔무통계학차이(3.57％vs 16.67％).대조조적평균혈소판계수[(158.5±82.9)×109/L]저우관찰조[(231.3±45.2)×109/L].결론 재주동맥구낭반박술중,여보통간소비교,채용저분자간소수연대병정개선급병사솔적영향무명현차이,단가이현저개선각류출혈병발증,병차대혈소판적영향경소,추천재주동맥구낭반박술중사용저분자간소체대보통간소작위항응제.
Objective To explore the efficacy of low molecular weight heparin versus that of unfractionated heparin in intra-aortic balloon counterpulsation.Methods 28 patients who received low-molecular-weight heparin during intra-aortic balloon counterpulsation were assigned to study group,while 30 patients who received unfractionated heparin were allocated to control group.The efficacy was compared between the two groups.Results The immediate improvement rate of disease severity and the mortality rate within 30 days did not differ significantly between the two groups [(67.86％ vs.56.67％) and (10.71％ vs.16.67％),(P＞ 0.05)].The incidence rate of complications including bleeding and hematoma was significantly lower in the study group than in the control group (7.14％ vs.30％),with a relative risk ratio of 4.200.There were no significant differences in the incidence of plug formation in balloon center and that of lower limb ischemia between the two groups (3.57％ vs.16.67％).The mean platelet count was lower in the control group than in the study group [(158.5 ± 82.9) × 109/L vs.(231.3 ± 45.2) × 109/L].Conclusions During intra-aortic balloon counterpulsation,as compared with unfractionated heparin,although low-molecular-weight heparin has no marked effect on disease severity and rate of mortality,it significantly lowers the rate of bleeding and has less impact on platelet.Low-molecular-weight heparin can replace unfractionated heparin as an anticoagulant during intra-aortic balloon counterpulsation.
