低分子肝素在冠脉造影和PCI术中抗凝的有效性和安全性研究  

Study on anticoagulation efficacy and safety of low molecular weight heparin used in coronary angiography and PCI

作　　者：魏友平[1] 高招波[1] 范剑峰[1] 郑春华[1] 万明勇[1] 张春花[1] 熊旭华[1] 涂群芳[1] 

机构地区：[1]南昌市第一医院心内二科,江西南昌330008

出　　处：《中国医药导报》2011年第26期21-23,共3页China Medical Herald

基　　金：江西省南昌市科学技术局重点攻关及产业科技项目(项目编号:2007116-142)

摘　　要：目的：观察在冠脉造影和PCI术中鞘内注射低分子肝素（LMWH）抗凝的有效性和安全性。方法：将我院2006～2009年290例单独行冠脉造影或造影同时需行PCI术的患者分为两组，实验组1-40例，对照组150例。实验组在冠脉造影和PCI术中应用LMWH，对照组应用常规剂量的普通肝素。观察人选后30d内的主要终点事件（心源性死亡、心肌梗死、急诊血运重建、中风）及次要终点（血肿、假性动脉瘤、出血）事件发生情况。结果：在介入手术经鞘管弹丸式推注低分子肝素，入选后30d内两组术后主要终点事件发生率，对照组为0．67％，实验组无终点事件发生，对照组高于实验组，但差异无统计学意义（19〉0．05）。对照组动脉穿刺部位的假性动脉瘤6例（4．00％），皮下血肿13例（8．67％）；实验组分别为2例（1．43％）和4例（2．86％），均低于对照组，差异有统计学意义（P〈0．05）。结论：低分子肝素在冠脉造影和PCI术中应用安全，且明显减少周围血管并发症的发生。Objective： To observe the anticoagulation efficacy and safety of low molecular weight heparin （LMWH） in- trathecal injected in coronary angiography and PCI. Methods： 290 cases of single coronary angiography or PCI in our hospital from 2006 to 2009 were divided into experiment group （n=140） and control group （n=150）. Experiment group was treated with LMWH in the coronary angiography and PCI, and control group was treated with conventional dose unfractionated heparin. The primary endpoint events （cardiac death, myocardial infarction, emergency revascularization, stroke） and secondary endpoint （hematoma, false aneurysm, bleeding） events were observed within 30 days after registration. Results： LMWH was injected into the interventional sheath bolus after surgery, the incidence of the end point events in the control group （0.67%） was higher than that in the experiment group （0%） within 30 days after registration, but there was no significant difference in the two groups （P〉0.05）. There were 6 cases （4.00%） with false aneurysm and 13 cases （8.67%） with subcutaneous hematoma at arterial puncture site in the control group, it is higher than those in the experiment group [2 cases （1.43%）, 4 cases （2.86%）], and there was a significant difference between the two groups （P〈0.05）. Conclusion： LMWH in intraoperative coronary angiography and PCI is safe, and can reduce peripheral vascular complications.

关 键 词：冠脉造影术 PCI术 低分子肝素 临床疗效 

分 类 号：R814.43[医药卫生—影像医学与核医学]