中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2013年
3期
229-232
,共4页
廖祁伟%张伟华%光雪峰%鲁一兵
廖祁偉%張偉華%光雪峰%魯一兵
료기위%장위화%광설봉%로일병
动脉导管未闭%心脏导管插入术%血小板减少
動脈導管未閉%心髒導管插入術%血小闆減少
동맥도관미폐%심장도관삽입술%혈소판감소
Ductus arteriosus,patent%Heart catheterization%Thrombocytopenia
目的 探讨动脉导管未闭(PDA)患者介入封堵术后血小板减少的相关危险因素.方法 回顾性分析350例接受PDA封堵治疗患者的临床资料,其中14例患者术后出现血小板减少症.记录患者的年龄、性别、体质量、PDA直径、封堵器直径、平均肺动脉压力、术中肝素用量、封堵器厂家和术后有无残余分流,并分析封堵术后血小板减少的独立危险因素.对患者术后血小板数量减少的程度进行分级,分析不同分级患者血小板计数恢复正常的时间.结果 多因素logistic回归分析显示,封堵器直径(OR=2.238,P＜0.05)、术中肝素用量(OR=1.912,P＜0.05)、术后有无残余分流(OR=3.247,P＜0.01)是PDA封堵术后血小板减少的危险因素.对轻度血小板减少的患者不予临床干预,其血小板恢复时间为(7±2)d;对中度血小板减少的患者给予糖皮质激素治疗后,血小板恢复正常时间为(12±4)d;对重度血小板减少的患者输注血小板后,血小板恢复正常的时间为(21±7)d.结论 封堵器直径、术中肝素用量、术后有无残余分流可能是导致PDA封堵术后血小板减少的危险因素.根据术后血小板减少程度的不同,通过临床观察及治疗,患者的血小板计数在不同时间内可恢复正常.
目的 探討動脈導管未閉(PDA)患者介入封堵術後血小闆減少的相關危險因素.方法 迴顧性分析350例接受PDA封堵治療患者的臨床資料,其中14例患者術後齣現血小闆減少癥.記錄患者的年齡、性彆、體質量、PDA直徑、封堵器直徑、平均肺動脈壓力、術中肝素用量、封堵器廠傢和術後有無殘餘分流,併分析封堵術後血小闆減少的獨立危險因素.對患者術後血小闆數量減少的程度進行分級,分析不同分級患者血小闆計數恢複正常的時間.結果 多因素logistic迴歸分析顯示,封堵器直徑(OR=2.238,P＜0.05)、術中肝素用量(OR=1.912,P＜0.05)、術後有無殘餘分流(OR=3.247,P＜0.01)是PDA封堵術後血小闆減少的危險因素.對輕度血小闆減少的患者不予臨床榦預,其血小闆恢複時間為(7±2)d;對中度血小闆減少的患者給予糖皮質激素治療後,血小闆恢複正常時間為(12±4)d;對重度血小闆減少的患者輸註血小闆後,血小闆恢複正常的時間為(21±7)d.結論 封堵器直徑、術中肝素用量、術後有無殘餘分流可能是導緻PDA封堵術後血小闆減少的危險因素.根據術後血小闆減少程度的不同,通過臨床觀察及治療,患者的血小闆計數在不同時間內可恢複正常.
목적 탐토동맥도관미폐(PDA)환자개입봉도술후혈소판감소적상관위험인소.방법 회고성분석350례접수PDA봉도치료환자적림상자료,기중14례환자술후출현혈소판감소증.기록환자적년령、성별、체질량、PDA직경、봉도기직경、평균폐동맥압력、술중간소용량、봉도기엄가화술후유무잔여분류,병분석봉도술후혈소판감소적독립위험인소.대환자술후혈소판수량감소적정도진행분급,분석불동분급환자혈소판계수회복정상적시간.결과 다인소logistic회귀분석현시,봉도기직경(OR=2.238,P＜0.05)、술중간소용량(OR=1.912,P＜0.05)、술후유무잔여분류(OR=3.247,P＜0.01)시PDA봉도술후혈소판감소적위험인소.대경도혈소판감소적환자불여림상간예,기혈소판회복시간위(7±2)d;대중도혈소판감소적환자급여당피질격소치료후,혈소판회복정상시간위(12±4)d;대중도혈소판감소적환자수주혈소판후,혈소판회복정상적시간위(21±7)d.결론 봉도기직경、술중간소용량、술후유무잔여분류가능시도치PDA봉도술후혈소판감소적위험인소.근거술후혈소판감소정도적불동,통과림상관찰급치료,환자적혈소판계수재불동시간내가회복정상.
Objective To explore the risk factors of patent ductus arteriosus (PDA) patients with thrombocytopenia after PDA interventional occlusion.Methods Thrombocytopenia occurred in 14 out of 350 patients underwent PDA occlusion.Age,gender,body weight,PDA size,occluder size,mean pulmonary arterial pressure,the dose of heparin,the manufacturer of occluder,residual shunt after operation were analyzed.The recovery time of different grades of thrombocytopenia was observed.Results Multiwariate logistic regression showed that the PDA size (OR =2.238,P ＜ O.05),the dose of heparin (OR =3.247,P ＜ 0.05),residual shunt after operation (OR =1.912,P ＜ 0.01) were the independent risk factors of thrombocytopenia after PDA occlusion.The recovery time of mild thrombocytopenia was (7 ± 2)days without treatment.The recovery time of moderate thrombocytopenia was (12 ± 4) days with glucocorticoids treatment.The recovery time of severe thrombocytopenia was (21 ± 7) days with platelet transfusion.Conclusions The occluder size,dose of heparin,residual shunt are the independent risk factors of thrombocytopenia after PDA interventional occlusion.Recover time of thrombocytopenia after PDA interventional occlusion is closely related to the severity of thrombocytopenia.
