达比加群酯与华法林在持续性心房颤动射频消融术患者围术期抗凝中应用对比研究  

Comparative study on dabigatran etexilate and warfarin in perioperative anti-coagulation of patients with persistent atrial fibrillation treated by radiofrequency ablation

作　　者：周音频[1] 胡龙江[1] 向立权[1] 胡鑫渝 宁琳[1] 肖鹏[1] 陈林[2] 

机构地区：[1]重庆市涪陵中心医院心内科,408000 [2]第三军医大学新桥医院心血管外科

出　　处：《山西医药杂志》2017年第18期2171-2174,共4页Shanxi Medical Journal

基　　金：重庆市医学科研计划项目(2013-1-056)

摘　　要：目的对比分析达比加群酯与华法林在持续性心房颤动射频消融术患者围术期抗凝中的应用效果。方法选取2016年2月至2017年2月我院和第三军医大学新桥医院收治的持续性心房颤动患者88例,根据随机数表法将所有患者分为2组,每组各44例。2组患者均于我院和第三军医大学新桥医院接受射频消融术治疗,对照组围术期应用华法林进行抗凝,观察组采用达比加群酯进行抗凝。比较2组治疗前、治疗3个月后凝血功能指标以及并发症、出血事件发生率。结果治疗前,2组凝血功能指标相比,差异无统计学意义(P>0.05);治疗后,2组PT、APTT、TT均明显长于治疗前,其中观察组APTT、TT明显长于对照组,差异有统计学意义(P<0.05);观察组并发症发生率明显低于对照组,差异有统计学意义(P<0.05);观察组出血事件发生率略低于对照组,差异无统计学意义(P>0.05)。结论达比加群酯与华法林均可作为持续性心房颤动射频消融术患者围术期的抗凝药物,其中达比加群酯具有更强的抗凝作用,同时有助于降低并发症发生率,减少出血事件的发生。Objective To compare and analyze the application effects of dabigatran etexilate and warfarin in perioperative anti-coagulation of patients with persistent atrial fibrillation treated by radiofrequency ablation.Methods Eight-eighty patients with persistent atrial fibrillation treated in our hospital and Xinqiao hospital of third military medical university from February 2016 to February 2017 were selected,and they were divided into two groups by random number table,44 cases in each group.Two groups received radiofrequency ablation in our hospital and Xinqiao hospital of third military medical university,the control group was given warfarin in perioperative anti-coagulation,while the observation group was given dabigatran etexilate in perioperative anti-coagulation.The indexes of coagulation function,complications,incidence of bleeding events before treatment and 3months after treatment were compared between the two groups.Results Before treatment,the indexes of coagulation function in two groups had no statistical difference（P〉0.05）.After treatment,the PT,APTT,TT of two groups were longer than those before treatment,the APTT,TT in observation group were longer than those in control group（P〈0.05）;The incidence of complications in observation group was lower than that in control group（P〈0.05）;The incidence of bleeding events in observation was slightly lower than that in control group,there was no statistical difference（P〉0.05）.Conclusion Dabigatran etexilate and warfarin are able to be perioperative anticoagulation drugs in patients with persistent atrial fibrillation received radiofrequency ablation,and the efficacy of dabigatran etexilate is better,which can reduce the incidence of complications and bleeding events.

关 键 词：心房颤动 达比加群酯 华法林 围手术期医护 抗凝血药 

分 类 号：R541.75[医药卫生—心血管疾病]