中国医药
中國醫藥
중국의약
CHINA MEDICINE
2013年
10期
1367-1369
,共3页
陈妍%孟康%张金荣%曾哲淳%郭成军%李海宴%方冬平%林运%戴文龙
陳妍%孟康%張金榮%曾哲淳%郭成軍%李海宴%方鼕平%林運%戴文龍
진연%맹강%장금영%증철순%곽성군%리해연%방동평%림운%대문룡
华法林%起搏器植入%囊袋血肿
華法林%起搏器植入%囊袋血腫
화법림%기박기식입%낭대혈종
Warfarin%Pacemaker implantation%Pocket hematoma
目的 观察围术期继续应用华法林对起搏器囊袋血肿发生率的影响.方法 180例服用华法林的患者接受永久起搏器植入,按照随机表随机分成继续华法林组和肝素桥接组,各90例.继续华法林组患者给予围术期内监测凝血酶原国际化比值,并维持华法林治疗(华法林剂量3.0～6.0 mg)；肝素桥接组患者围术期内采用低分子肝素桥接[1 mg/(kg·12 h)],观察住院期间2周内囊袋的血肿发生率.结果 继续华法林组囊袋血肿发生率为6.7％ (6/90),肝素桥接组为17.8％ (16/90),2组比较差异有统计学意义(P=0.023).Logistic回归分析显示低分子肝素为发生囊袋血肿的独立危险因素(RR=2.665,95％ CI=1.073～8.156,P=0.023).结论 与肝素桥接法比较,围术期继续服用华法林不明显增加起搏器囊袋血肿发生率.
目的 觀察圍術期繼續應用華法林對起搏器囊袋血腫髮生率的影響.方法 180例服用華法林的患者接受永久起搏器植入,按照隨機錶隨機分成繼續華法林組和肝素橋接組,各90例.繼續華法林組患者給予圍術期內鑑測凝血酶原國際化比值,併維持華法林治療(華法林劑量3.0～6.0 mg)；肝素橋接組患者圍術期內採用低分子肝素橋接[1 mg/(kg·12 h)],觀察住院期間2週內囊袋的血腫髮生率.結果 繼續華法林組囊袋血腫髮生率為6.7％ (6/90),肝素橋接組為17.8％ (16/90),2組比較差異有統計學意義(P=0.023).Logistic迴歸分析顯示低分子肝素為髮生囊袋血腫的獨立危險因素(RR=2.665,95％ CI=1.073～8.156,P=0.023).結論 與肝素橋接法比較,圍術期繼續服用華法林不明顯增加起搏器囊袋血腫髮生率.
목적 관찰위술기계속응용화법림대기박기낭대혈종발생솔적영향.방법 180례복용화법림적환자접수영구기박기식입,안조수궤표수궤분성계속화법림조화간소교접조,각90례.계속화법림조환자급여위술기내감측응혈매원국제화비치,병유지화법림치료(화법림제량3.0～6.0 mg)；간소교접조환자위술기내채용저분자간소교접[1 mg/(kg·12 h)],관찰주원기간2주내낭대적혈종발생솔.결과 계속화법림조낭대혈종발생솔위6.7％ (6/90),간소교접조위17.8％ (16/90),2조비교차이유통계학의의(P=0.023).Logistic회귀분석현시저분자간소위발생낭대혈종적독립위험인소(RR=2.665,95％ CI=1.073～8.156,P=0.023).결론 여간소교접법비교,위술기계속복용화법림불명현증가기박기낭대혈종발생솔.
Objective To investigate the effect of continuation of warfarin sodium on the incidence of pocket hematoma compared to heparin bridging.Methods We studied 180 consecutive patients taking warfarin long term underwent pacemaker-implanting procedures.Patients were classified into two groups.The first group continued warfarin therapy while maintain a therapeutic INR within a "safe" range (n =90).The second adopted heparin bridging strategy (n =90).Within 2 weeks after pacemaker implanting surgery during hospitalization.Results Twenty-two patients (12.2％) had pocket hematoma.Six patients (6.7％) from continuing warfarin group and 16/90(17.8％) from heparin bridging group (P =0.023).Logistic regression analysis showed that low molecular weight heparin was an independent risk factor for the development of pocket hematoma (RR =2.665,95％ CI:1.073-8.156,P =0.023).Conclusion Continuation of oral anticoagulation therapy with an INR level of 2-3 does not increase the risk of pocket hematoma occurrence,while precaution is still necessary to avoid supra therapeutic warfarin.
