中华心律失常学杂志
中華心律失常學雜誌
중화심률실상학잡지
CHINESE JOURNAL OF CARDIAC ARRHYTHMIAS
2012年
5期
330-333
,共4页
田颖%齐淑媛%卢晓英%陈汝明%尹先东%周旭%石亮%王彦江%杨新春%刘兴鹏
田穎%齊淑媛%盧曉英%陳汝明%尹先東%週旭%石亮%王彥江%楊新春%劉興鵬
전영%제숙원%로효영%진여명%윤선동%주욱%석량%왕언강%양신춘%류흥붕
抗凝管理服务%心房颤动%射频导管消融%国际标准化比值
抗凝管理服務%心房顫動%射頻導管消融%國際標準化比值
항응관리복무%심방전동%사빈도관소융%국제표준화비치
Anticoagulation management service%Atrial fibrillation%Radiofrequency catheter ablation%International normalized ratio
目的 评价抗凝管理服务(AMS)在心房颤动(房颤)导管消融术后患者中的应用价值.方法 连续245例[男134例,年龄(64±11)岁]接受导管消融治疗的房颤患者,所有患者术后均接受口服华法林抗凝治疗3～6个月.其中,前116例随机就诊于心内科门诊并接受华法林剂量调整(非AMS组),后129例接受经过培训的专业护士指导下的华法林剂量调整(AMS组).比较两组的国际标准化比值(INR)达标率(INR值位于2.0～3.0之间)、有效抗凝率(≥70％的INR测定值达标)及INR波动指数(达标后的最大INR值-达标后最小INR值-1).结果 AMS组的INR达标率(92.2％)和有效抗凝率(59.8％)均显著高于非AMS组(分别为80.2％和42.7％,P值分别为0.008和0.027).AMS组的INR波动指数0.64±0.74显著小于非AMS组(1.01±1.03,P=0.004).结论 在房颤导管消融术后应用华法林抗凝治疗的患者中系统应用AMS有助于提高抗凝治疗的达标率和有效抗凝率,并减小INR值的波动性.
目的 評價抗凝管理服務(AMS)在心房顫動(房顫)導管消融術後患者中的應用價值.方法 連續245例[男134例,年齡(64±11)歲]接受導管消融治療的房顫患者,所有患者術後均接受口服華法林抗凝治療3～6箇月.其中,前116例隨機就診于心內科門診併接受華法林劑量調整(非AMS組),後129例接受經過培訓的專業護士指導下的華法林劑量調整(AMS組).比較兩組的國際標準化比值(INR)達標率(INR值位于2.0～3.0之間)、有效抗凝率(≥70％的INR測定值達標)及INR波動指數(達標後的最大INR值-達標後最小INR值-1).結果 AMS組的INR達標率(92.2％)和有效抗凝率(59.8％)均顯著高于非AMS組(分彆為80.2％和42.7％,P值分彆為0.008和0.027).AMS組的INR波動指數0.64±0.74顯著小于非AMS組(1.01±1.03,P=0.004).結論 在房顫導管消融術後應用華法林抗凝治療的患者中繫統應用AMS有助于提高抗凝治療的達標率和有效抗凝率,併減小INR值的波動性.
목적 평개항응관리복무(AMS)재심방전동(방전)도관소융술후환자중적응용개치.방법 련속245례[남134례,년령(64±11)세]접수도관소융치료적방전환자,소유환자술후균접수구복화법림항응치료3～6개월.기중,전116례수궤취진우심내과문진병접수화법림제량조정(비AMS조),후129례접수경과배훈적전업호사지도하적화법림제량조정(AMS조).비교량조적국제표준화비치(INR)체표솔(INR치위우2.0～3.0지간)、유효항응솔(≥70％적INR측정치체표)급INR파동지수(체표후적최대INR치-체표후최소INR치-1).결과 AMS조적INR체표솔(92.2％)화유효항응솔(59.8％)균현저고우비AMS조(분별위80.2％화42.7％,P치분별위0.008화0.027).AMS조적INR파동지수0.64±0.74현저소우비AMS조(1.01±1.03,P=0.004).결론 재방전도관소융술후응용화법림항응치료적환자중계통응용AMS유조우제고항응치료적체표솔화유효항응솔,병감소INR치적파동성.
Objective To evaluate the effectiveness of anticoagulation management service (AMS) in patients who underwent catheter ablation for atrial fibrillation (AF).Methods Two hundreds and forty-five consecutive patients [134 males; age (64 ± 11) years] with AF were enrolled.All patients received warfarin therapy for 3 ～ 6 months after catheter ablation for AF.Patients adjusted their warfarin doses either by visiting the outpatient clinic (the former 116 patients,non-AMS group) or under the guidance of one well-trained nurse (the latter 129 patients,AMS group).The percentage of patients in whom the international normalized ratio (INR) value achieved therapeutic anticoagulation range (2.0 ～ 3.0),the effective anticoagulation rate that defined as more than 70％ of INR values were between 2.0 ～ 3.0 after titration period,and the INR fluctuation index after titration period were compared between the 2 groups.Results Warfarin therapy rendered 119 patients (92.2％) in AMS group and 93 patients (80.2％) in non-AMS group achieved therapeutic anticoagulation range (P=0.008).The effective anticoagulation rate in AMS group (59.8％) was significantly higher than that in non-AMS group (42.7％,P =0.027),while the INR fluctuation index in AMS group were significantly less than that in non-AMS group(0.64±0.74 vs 1.01±1.03,P=0.004).Conclusion This study demonstrates that the application of AMS in patients who underwent catheter ablation of AF is helpful in achieving higher effective anticoagulation rate while keeping therapeutic INR value more stable.
