室上性心动过速射频消融术后股静脉加压包扎2h与6h出血及栓塞并发症比较  

Comparison of bleeding and thromboembolism complications for the time of the compression bandage between 2 and 6 hours through femoral vein after radiofrequency ablation diagnosed as supraventricular tachycardia

作　　者：郭兰燕[1] 张殿新[1] 程何祥[1] 沈敏[1] 易甫[1] 武峰[1] 李静霞[1] 杨华[1] 刘兵[1] 

机构地区：[1]第四军医大学西京医院心内科,陕西西安710032

出　　处：《中国心脏起搏与心电生理杂志》2016年第6期513-516,共4页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的比较经股静脉入径行射频消融(RFCA)术后加压包扎2h与6h的出血及栓塞并发症。方法选取因阵发性心动过速行电生理检查证实为房室结折返性心动过速和房室折返性心动过速(右侧旁路)行RFCA的患者120例,根据术后加压包扎的时间分为两组:2h组60例,6h组60例。对比两组间活化凝血时间(ACT)、术后患者不适感、局部血肿、动静脉瘘、血栓栓塞等并发症的发生率。结果 1术前两组间血小板、血凝系列和ACT无显著差异(P>0.05)。22h组术前和术后2h以及6h组术前和术后6hACT均无差异(P>0.05),但术后即刻均与术前、术后床旁(2h/6h)的ACT有显著差异(P<0.05)。另外,两组间术前、术后即刻、术后2h与6h之间均无差异(P>0.05)。两组分别有2例和1例局部淤血瘀斑发生,均无局部血肿、假性动脉瘤、动静脉瘘、血栓栓塞等发生(P>0.05)。2h组患者舒适度明显高于6h组(P<0.05)。3多因素线性相关分析发现,ACT与年龄呈正相关(r=0.315,P=0.023)。结论 RFCA术后股静脉加压包扎2h可能安全可行,无更多的出血事件发生,且病人的舒适性改善。Objective To observe the occurrence of bleeding and thromboembolism complications for the time of the compression bandage between 2and 6hours through femoral vein after radiofrequency ablation diagnosed as supraventricular tachycardia. Methods One hundred and twenty patients were admitted in our hospital,verified as atrioventricular nodal reentrant tachycardia and atrioventricular reentrant tachycardia（right-sided accessory pathways）.According to the time of the compression bandage,all the patients were divided into two groups：2hgroup（group A,n=60）and 6hgroup（groupB,n=60）.The level of activated coagulation time（ACT）,patients′comfort,local hematoma,pseudoaneurysm,arterio-venous fistula and thromboembolism were compared between the two groups. Results（1）Before the intervention,the differences of activated partical thromboplastin time,prothrombin time,antithrombin activity,thrombin time,platelet,and ACT between the two groups were non-significant（P〉 0.05）.（2）There was no evident difference in ACT after the intervention for 2hand 6hbetween the two groups（P〉0.05）.However,there was statistical significance in ACT between just when the intervention ended and pre-or postintervention for 2hand 6h（P 〈0.05）.There was no local hematoma,arterio-venous fistula,pseudoaneurysm or thromboembolism in both groups.Totally,2（3%）and 1（2%）local ecchymosis occurred in group A and group B,respectively（P〉0.05）.However,the patients′discomfort of group A was less than that of group B（P=0.023）.（3）Multifactor linear correlation analysis showed that age was related to ACT level（r=0.315,P〈0.05）,but otherswere not related to ACT level（all P〉0.05）. Conclusion The compression bandage for 2hours after radiofrequency ablation through the femoral vein pathway may be safe and feasible.

关 键 词：心血管病学 射频消融术 经股静脉 加压包扎时间 并发症 

分 类 号：R541.71[医药卫生—心血管疾病] R454.1[医药卫生—内科学]