替罗非班在支架辅助栓塞颅内动脉瘤术中的应用  

A Clinical Study of Preventive Application of Tirofiban during Stent-Assisted Coiling Therapy for Intracraninal Aneurysms

作　　者：郑海涛[1] 宋浩青[1] 杨廷舰[1] 刘伟[1] 王飞[1] 邵显敏 

机构地区：[1]潍坊医学院,山东潍坊261031

出　　处：《湖北民族学院学报（医学版）》2016年第1期35-37,共3页Journal of Hubei Minzu University(Medical Edition)

摘　　要：目的观察替罗非班在颅内动脉瘤患者择期行支架辅助栓塞治疗（SAC）术中应用的疗效和安全性。方法47例（52个动脉瘤）颅内动脉瘤择期行SAC术患者分为替罗非班组16例和非替罗非班组31例。替罗非班组在SAC术中即刻应用替罗非班（0.10μg/（kg·min）,静脉持续泵入12h）行抗血小板（PLT）聚集治疗,术后12h逐渐过渡到常规剂量阿司匹林口服（100mg/d,连续6个月）和氯吡格雷（75mg/d,持续4~6周）;非替罗非班组除不用替罗非班外,治疗均与替罗非班组相同。观察SAC术治疗前后PLT计数、部分活化凝血酶原时间（APTT）值及术中脑栓塞、脑出血发生情况。结果两组手术前后血小板计数及APTT值发生率比较,差别无统计学意义（P〉0.05）,替罗非班组术中急性血栓发生率明显低于非替罗非班组（P〈0.05）,脑出血发生率两组差别无统计学意义（P〉0.05）。结论颅内动脉瘤患者择期行SAC术中预防性应用替罗非班是安全的,择期SAC术中常规使用替罗非班可以降低动脉瘤术中脑栓塞的发生率。Objective To obseve the efficiency and safety of preventive application of tirofiban during the elective stent-assisted coiling therapy for intracraninal aneurysms.Methods This anal- ysis was conducted in 4？patients with 52 intracranial aneurysms who had been treated by coil embolization from January, 2013 to December, 2015.16 patients were assigned to the tirofiban team and 31 patients were distributed to the no triofiban team.Tirofiban was used immediately during SAC operation （0.10 μg/（ kg · min） continuous infusion pump for 12 hours） for antiplatelet aggregation, then gradual transiting to the regular oral dose of aspirin（ 100-200 mg,qd,for 6 months） and clopidogrel（75mg qd for 4-6 weeks）. There was no triofiban therapy in the no tirofiban team, while the rest of treatment was the same.The PLT （platelet count）, APTT （activated partial thromboplastin time）, the incidence of cerebral thrombosis and cerebral hemor- rhage were observed preoperative and postoperative SAC operation.Results The PLT,ATPP val- ue and the incidence of cerebral hemorrhage had no significant difference between the two groups preoperative and postoperative the operation （P〉0.05）.There was a significant differ- ence in the incidence of cerebral embolism （P〈0. 05）.Conclusion It is safe to use tirofiban during the elective SAC therapy for the intracranial aneurysm patients.The routine use of tirofiban during SAC in patients undergoing elective surgery can reduce the incidence of intraoperative cerebral embolism aneurysms.

关 键 词：颅内动脉瘤 替罗非班 支架辅助栓塞 预防性应用 

分 类 号：R739.41[医药卫生—肿瘤]