抗凝对右心导管操作术后深静脉血栓发生的影响  

Impact of Anticoagulation on Deep Vein Thrombosis Occurrence in Patients After Right Heart Catheterization

作　　者：匡晓晖 张曦[1] 高晓龙[1] 王礼琳[1] 丁立群[1] 张进[1] 向虹[1] 彭亚婷[1] 高田[1] 毛富刚[1] 范洁[1] 

机构地区：[1]云南省第一人民医院心内科,昆明市650032

出　　处：《中国循环杂志》2017年第8期776-779,共4页Chinese Circulation Journal

基　　金：云南省科技厅重点项目(2014RA069)

摘　　要：目的:探索右心导管操作术后深静脉血栓(DVT)的发生率及抗凝治疗的作用。方法:连续选择2015-01至2016-05行心内电生理检查(EPS)和(或)导管射频消融(RFCA)的患者171例,将在静脉系统可完成手术的室上性心动过速(室上速)患者随机分为抗凝组87例及非抗凝组84例。术后24~48 h行下肢血管多普勒彩超检查,比较二组间DVT发生率。结果:171例患者均为阵发性室上速患者,13例患者(抗凝组9例,非抗凝组4例)未完成术后下肢血管多普勒彩超检查而排除,共有158例患者完成术后检查及随访。抗凝组78例中有7例(8.97%)发生DVT;非抗凝组80例中有41例(51.3%)发生DVT,两组比较差异有统计学意义(P<0.001)。48例发生DVT患者中有6例(12.5%)发生肌间静脉血栓,42例均为静脉穿刺点附近血栓。结论:右心导管操作术中未抗凝的患者DVT发生率较高,使用肝素抗凝可降低DVT发生率。Objective： To explore deep vein thrombosis（DVT） occurrence in patients after right heart catheterization and the effect of anticoagulant therapy.Methods： A total of 171 consecutive patients with electrophysiological study（EPS） and/or radiofrequency catheter ablation（RFCA） in our hospital from 2015-01 to 2016-05 were enrolled. All patients had supra-ventricular tachycardia and completed a venous surgery, they were randomly divided into 2 groups： Anticoagulation group, n=87 and Non-anticoagulation group, n=84. Lower extremity vascular Doppler ultrasonography was performed at（24-48） h post-operation to compare the incidence of DVT between 2 groups.Results： There were 13/171 patients were excluded for not completing post-operative lower extremity vascular Doppler ultrasonography including 9 patients in Anticoagulation group and 4 in Non-anticoagulation group. 158 patients finished post-operative examination and follow-up study. Anticoagulation group had 7/78（8.97%） patients suffered from DVT, Nonanticoagulation group had 41/80（51.3%） patients suffered from DVT, P〈0.001.Conclusion： The incidence of DVT was higher after right heart catheterization without anticoagulation; heparin treatment may reduce DVT occurrence in relevant patients.

关 键 词：导管插入术 静脉血栓形成 抗凝药 

分 类 号：R541[医药卫生—心血管疾病]