围手术期不同抗凝策略对病窦综合征合并心房颤动患者起搏器植入术后囊袋相关并发症及血栓栓塞事件的影响  

The impact of different perioperative anticoagulation strategy on pocket related complications and thromboembolic events after pacemaker implantation in patients with sick sinus syndrome and atrial fibrillation

作　　者：陈慧玲[1] 李赐恩[2] 宋卫锋[1] 王顺保[1] 马继芳[1] 臧小彪[1] 陈珂[1] 张嘉莹[1] 

机构地区：[1]郑州大学人民医院心内科,河南郑州450003 [2]郑州大学第一附属医院心内科,河南郑州450000

出　　处：《中国心脏起搏与心电生理杂志》2016年第1期19-21,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：河南省科技攻关计划项目(项目编号:112102310265)

摘　　要：目的观察围手术期不同抗凝策略对病窦综合征(SSS)合并心房颤动(AF)患者起搏器植入术后囊袋相关并发症及血栓栓塞事件的影响。方法将84例应用华法林抗凝的SSS合并AF需要接受起搏器植入的患者分为3组。A组:围手术期不中断华法林;B组:停用华法林,低分子肝素桥接治疗;C组:停用华法林。观察术后1年内囊袋相关并发症及血栓栓塞事件的发生情况。结果 A组出现囊袋血肿2例;B组出现囊袋血肿3例,其中1例囊袋破溃并拔除起搏系统;C组囊袋血肿2例。A、B组均无血栓栓塞事件发生;C组围手术期出现急性脑梗塞2例。结论 SSS合并持续性AF卒中中高危患者起搏器植入不停用华法林未明显增加囊袋相关并发症,未出现明显血栓栓塞事件。Objective To investigate the impact of different ed complications and thromboembolic events after pacemaker perioperative anticoagulation strategy on pocket relat-implantation in patients with SSS and AF. Methods Eighty-four cases of SSS and AF patients who undergoing pacemaker implantation and warfarin anticoagulation were divided into three groups. A group： don＇t interrupt warfarin applications; B group： Stop using warfarin, changed to low molecular heparin bridging therapy;C group： Stop using warfarin. The pouch related complications and postoperative thrornboembolic events were observed within 1 year following the operation. Result In group A, pocket hematoma occurred in two cases; In group B,pocket hematoma occurred in three cases, among them one case appeared pouch burst, finally the pacemaker system was removed; In group C,pocket hematoma occurred in two cases. There were no thromboembolic events in group A and B , acute cerebral infarction occurred in two cases in Group C. Conclusion The pouch related complications have no significant increases by no interrupting warfarin applications in SSS and AF patients who undergoing pacemaker implantation with middle and high stroke risk. No apparent thromboembolic events are noted by no interrupting warfarin applications in the study.

关 键 词：心血管病学 病窦综合征 心房颤动 抗凝 起搏器植入 并发症 

分 类 号：R541.71[医药卫生—心血管疾病] R318.11[医药卫生—内科学]