中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2013年
19期
35-37
,共3页
老年人%经皮冠状动脉介入治疗%双联抗血小板%治疗
老年人%經皮冠狀動脈介入治療%雙聯抗血小闆%治療
노년인%경피관상동맥개입치료%쌍련항혈소판%치료
Elderly patients%Percutaneous coronary intervention%Double antiplatelet therapy%Treatment
目的 观察老年患者经皮冠状动脉介入治疗(PCI)术后氯吡格雷联合阿司匹林抗血小板治疗的有效性及安全性.方法 对145例老年患者PCI术后进行1年的动态随访观察,所有患者均于PCI术前3d开始服用氯吡格雷,首剂300 mg,以后75 mg,每天1次,阿司匹林肠溶片0.1g,每天1次；术中均选择经桡动脉途径行冠状动脉支架置入术；术后低分子肝素5000 U每12小时静脉滴注,连用3d；出院后双联抗血小板治疗1年.动态随访观察所有患者PCI术后1、3、6个月及1年时急性血栓、亚急性血栓、晚期血栓的发生率,术后主要心血管不良事件(MACE)包括心源性死亡、再次心肌梗死、再发心绞痛、继发心力衰竭及再次入院治疗,术后再狭窄及临床出血事件包括脑出血、消化道出血及皮下出血的情况.结果 145例老年患者中多支病变56例,双支病变47例,单支病变42例,共置入支架225枚,所有患者手术顺利,随访期间出现消化道出血2例,牙龈及皮下瘀斑4例,无颅内出血,无心源性死亡,再发心绞痛5例.结论 老年患者PCI围术期双联抗血小板治疗,尤其术后长期双抗治疗起到了显著的抗血小板作用,同时不良反应小,随访期间未出现急性冠状动脉事件,可改善老年患者的生活质量,临床使用安全可靠.
目的 觀察老年患者經皮冠狀動脈介入治療(PCI)術後氯吡格雷聯閤阿司匹林抗血小闆治療的有效性及安全性.方法 對145例老年患者PCI術後進行1年的動態隨訪觀察,所有患者均于PCI術前3d開始服用氯吡格雷,首劑300 mg,以後75 mg,每天1次,阿司匹林腸溶片0.1g,每天1次；術中均選擇經橈動脈途徑行冠狀動脈支架置入術；術後低分子肝素5000 U每12小時靜脈滴註,連用3d；齣院後雙聯抗血小闆治療1年.動態隨訪觀察所有患者PCI術後1、3、6箇月及1年時急性血栓、亞急性血栓、晚期血栓的髮生率,術後主要心血管不良事件(MACE)包括心源性死亡、再次心肌梗死、再髮心絞痛、繼髮心力衰竭及再次入院治療,術後再狹窄及臨床齣血事件包括腦齣血、消化道齣血及皮下齣血的情況.結果 145例老年患者中多支病變56例,雙支病變47例,單支病變42例,共置入支架225枚,所有患者手術順利,隨訪期間齣現消化道齣血2例,牙齦及皮下瘀斑4例,無顱內齣血,無心源性死亡,再髮心絞痛5例.結論 老年患者PCI圍術期雙聯抗血小闆治療,尤其術後長期雙抗治療起到瞭顯著的抗血小闆作用,同時不良反應小,隨訪期間未齣現急性冠狀動脈事件,可改善老年患者的生活質量,臨床使用安全可靠.
목적 관찰노년환자경피관상동맥개입치료(PCI)술후록필격뢰연합아사필림항혈소판치료적유효성급안전성.방법 대145례노년환자PCI술후진행1년적동태수방관찰,소유환자균우PCI술전3d개시복용록필격뢰,수제300 mg,이후75 mg,매천1차,아사필림장용편0.1g,매천1차；술중균선택경뇨동맥도경행관상동맥지가치입술；술후저분자간소5000 U매12소시정맥적주,련용3d；출원후쌍련항혈소판치료1년.동태수방관찰소유환자PCI술후1、3、6개월급1년시급성혈전、아급성혈전、만기혈전적발생솔,술후주요심혈관불량사건(MACE)포괄심원성사망、재차심기경사、재발심교통、계발심력쇠갈급재차입원치료,술후재협착급림상출혈사건포괄뇌출혈、소화도출혈급피하출혈적정황.결과 145례노년환자중다지병변56례,쌍지병변47례,단지병변42례,공치입지가225매,소유환자수술순리,수방기간출현소화도출혈2례,아간급피하어반4례,무로내출혈,무심원성사망,재발심교통5례.결론 노년환자PCI위술기쌍련항혈소판치료,우기술후장기쌍항치료기도료현저적항혈소판작용,동시불량반응소,수방기간미출현급성관상동맥사건,가개선노년환자적생활질량,림상사용안전가고.
Objective To observe the efficacy and safety of clopidogrel combined with aspirin antiplatelet therapy in the treatment of elderly patients after PCI.Methods A total of 145 coronary heart disease (CHD)patients were followed up for one year after PCI,conventional preoperative preparation,clopidogrel and aspirin were prescribed for all CHD patients.The first dosage of clopidogrel was 300 mg,then 75 mg/d for one year.Aspirin 0.1 g/d was taken for one year.Postoperative low molecular weight heparin 5000 U,q12 h,intravenous infusion,continuous use for 3 days,double antiplatelet therapy for 1 year after discharge.Acute thrombosis,subacute and late thrombosis incidence in all patients after PCI,1,3 and 6 months and 1 year were dynamicly followed-up.The events of acute-subacute and late thrombosis in stent were observed.The bleeding events and vascular restenosis were also observed.Results There were 56 cases of multivessel disease,47 cases of double vessel disease,42 cases of single vessel disease.A total of 225 stents were applied.Subcutaneous ecchymosis gum in 4 cases,gastrointestinal bleeding in 2 cases,no intracranial hemorrhage,no heart deaths.Conclusions Perioperative dual antiplatelet therapy,especially after long-term double-antibody therapy in elderly patients with PCI,has significant anti-platelet effect and little side effects.During the follow-up period,there was no acute coronary events,it can improve the quality of life of elderly patients,the clinical use is safe and reliable.
