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目的:比较相对小分子质量肝素(LMWH)和普通肝素(UFH)预防左心导管术中血栓形成和出血并发症的发生率.方法:行左心导管术426例接导管号随机分成两组,分别于动脉鞘管内给予LMWH或UFH,LMWH按95IU/kg.UFH按50IU/kg体重给药.观察术中及术后血栓、出血现象的发生率.部分病人动态检测出、凝血时间及部分凝血活酶时间.结果:LMWH组与UFH组对比,总的全身出血现象发生率明显减少,分别为6.4%和24.5%,平均术后压迫止血时间明显缩短,分别为(10.2±16.2)和(28.4±20.1)min,用药1h后两组部分凝血活酶时间均较正常延长,4h UFH组离均差较大,提示各例间差异较大.4h UFH组仍延长,而LMWH组恢复正常.两组均无一例出现血栓栓塞.结论:LMWH组在左心导管术预防血栓并发症的有效性与UFH组相仿.但比UFH更安全.
Objective: To compare the incidence of thrombosis and bleeding complications in patients undergoing left heart catheterization with relatively small molecular weight heparin (LMWH) and unfractionated heparin (UFH) .Methods: 426 cases of catheterization under left heart catheterization were randomly divided into two groups, Respectively, in the arterial sheath to give LMWH or UFH, LMWH according to 95IU / kg.UFH by 50IU / kg body weight to observe the intraoperative and postoperative thrombosis, the incidence of bleeding.Partial patient dynamic detection, coagulation time and partial coagulation (10.2 ± 16.2) and (28.4), respectively.Results: Compared with UFH group, the incidence of total systemic hemorrhage was significantly decreased in LMWH group (6.4% vs 24.5%, respectively), and mean postoperative compression hemostasis time was significantly shorter ± 20.1) min. The time of partial thromboplastin in the two groups was longer than that in the normal group after 1h, and the difference of the average difference in the 4h group was larger, which indicated that there was a significant difference between the 4 groups, the prolongation of 4h UFH group and the return of normal to LMWH group. No thromboembolism occurred in any group.Conclusion: The efficacy of left ventricular catheterization in preventing thrombotic complications in LMWH group is similar to that in UFH group, but safer than UFH group.