中国医药
中國醫藥
중국의약
CHINA MEDICINE
2013年
10期
1361-1363
,共3页
孟康%张金荣%林运%曾哲淳%方冬平%郭成军%戴文龙%李海宴
孟康%張金榮%林運%曾哲淳%方鼕平%郭成軍%戴文龍%李海宴
맹강%장금영%림운%증철순%방동평%곽성군%대문룡%리해연
双重抗血小板药物%囊袋血肿%起搏装置%低分子肝素桥接
雙重抗血小闆藥物%囊袋血腫%起搏裝置%低分子肝素橋接
쌍중항혈소판약물%낭대혈종%기박장치%저분자간소교접
Dual anti-platelet%Pocket hematoma%Electric pacemaker device%Low molecular weight heparin bridging
目的 研究持续双重抗血小板药物(DAP)治疗对起搏器植入术后囊袋血肿的影响.方法 2010年6月至2013年1月,北京安贞医院长期服用DAP的起搏装置(EPD)植入的老年患者173例,完全随机分为2组,持续DAP治疗组(87例),围术期持续服用DAP,阿司匹林100 mg/d+氯比格雷75 mg/d；低分子肝素桥接组(86例)围术期暂停服用DAP,以依诺肝素[1 mg/(kg·12 h)]桥接治疗.随访观察2组患者EPD植入后围术期内囊袋血肿的发生率.结果 持续DAP治疗组囊袋血肿发生率为3.4％(3/87),低分子肝素桥接组的囊袋血肿发生率为16.3％ (14/87).2组比较差异有统计学意义(x2=11.73,P=0.003);手术时间、血肿形成时间在2组间差异有统计学意义(P＜0.05)；Logistic回归分析提示,低分子肝素为影响囊袋血肿的独立危险因素(P =0.025).结论 围术期持续DAP治疗不增加EPD植入后囊袋血肿的风险.
目的 研究持續雙重抗血小闆藥物(DAP)治療對起搏器植入術後囊袋血腫的影響.方法 2010年6月至2013年1月,北京安貞醫院長期服用DAP的起搏裝置(EPD)植入的老年患者173例,完全隨機分為2組,持續DAP治療組(87例),圍術期持續服用DAP,阿司匹林100 mg/d+氯比格雷75 mg/d；低分子肝素橋接組(86例)圍術期暫停服用DAP,以依諾肝素[1 mg/(kg·12 h)]橋接治療.隨訪觀察2組患者EPD植入後圍術期內囊袋血腫的髮生率.結果 持續DAP治療組囊袋血腫髮生率為3.4％(3/87),低分子肝素橋接組的囊袋血腫髮生率為16.3％ (14/87).2組比較差異有統計學意義(x2=11.73,P=0.003);手術時間、血腫形成時間在2組間差異有統計學意義(P＜0.05)；Logistic迴歸分析提示,低分子肝素為影響囊袋血腫的獨立危險因素(P =0.025).結論 圍術期持續DAP治療不增加EPD植入後囊袋血腫的風險.
목적 연구지속쌍중항혈소판약물(DAP)치료대기박기식입술후낭대혈종적영향.방법 2010년6월지2013년1월,북경안정의원장기복용DAP적기박장치(EPD)식입적노년환자173례,완전수궤분위2조,지속DAP치료조(87례),위술기지속복용DAP,아사필림100 mg/d+록비격뢰75 mg/d；저분자간소교접조(86례)위술기잠정복용DAP,이의낙간소[1 mg/(kg·12 h)]교접치료.수방관찰2조환자EPD식입후위술기내낭대혈종적발생솔.결과 지속DAP치료조낭대혈종발생솔위3.4％(3/87),저분자간소교접조적낭대혈종발생솔위16.3％ (14/87).2조비교차이유통계학의의(x2=11.73,P=0.003);수술시간、혈종형성시간재2조간차이유통계학의의(P＜0.05)；Logistic회귀분석제시,저분자간소위영향낭대혈종적독립위험인소(P =0.025).결론 위술기지속DAP치료불증가EPD식입후낭대혈종적풍험.
Objective To investigate the incidence of pocket hematoma after electrophysiological device (EPD) placements in patients with dual anti-platelet (DAP) and low molecular weight heparin (LMWH) bridging.Methods One hundred and seventy-three patients with dual antiplatelet drug received the pacemaker implantation and enrolled in this prospective observational analysis.Eighty-seven patients received continue DAP therapy,86 patients replaced DAP drugs with enoxaparin bridging.The adenosine phosphate-mediated platelet aggregation and the ratio platelet aggregation induced by the arachidonic acid (AA) were tested before operation.The incidence of pocket hematoma was investigated.Results Incidence of pocket hematoma in continuing DAP group was lower than that of discontinue dual AP therapy with (LMWH) bridging therapy group (3.4％ vs 16.3 ％,x2 =11.73,P =0.003).Patients with LMWH bridging were 5.102 fold more likely to develop pocket hematoma than DAP individuals.A multiple Logistic regression analysis revealed that LMWH was an independent risk factor for the development of pocket hematoma (P =0.025).Conclusion Continuing dual anti-platelet therapy does not increase the risk of pocket hematoma after antiarrhythmic device placement.
