论文部分内容阅读
目的 探讨冠状动脉支架置入术后是否应用肝素对临床预后的影响。方法 回顾性分析了 1998- 10～ 2 0 0 1- 10所有冠状动脉支架术病人在鞘管拔出后用或不用静脉肝素方案对住院期间、30d缺血事件和出血并发症的影响。结果 肝素组住院期间缺血并发症低于无肝素组 ,缺血并发症减少 5 8% (3.70 %vs 9.10 % ,P <0 .0 0 5 ) ,QMI减少 75 % (0 .2 9%vs 1.2 0 % ,P <0 .0 2 5 ) ,NQMI减少 6 5 % (1.5 0 %vs4 .35 % ,P <0 .0 0 5 ) ,靶血管再PTCA减少 78% (0 .90 %vs 4 .10 % ,P <0 .0 0 5 ) ,30d靶血管再梗死率降低 75 % (0 .34%vs 1.4 0 % ,P <0 .0 1) ;两组间出血并发症未见明显区别 (6 .0 0 %vs 5 .10 % ,P >0 .2 5 ) ;进一步分析发现 ,隔夜肝素组和 3d肝素组缺血和出血并发症也无明显区别 (2 .0 0 %vs3.90 % ,P>0 .1和 5 .90 %vs7.2 0 % ,P>0 .5 )。结论 冠状动脉支架术后常规应用肝素能减少住院期间和 30dQMI、NQMI、靶血管再PTCA的发生率和亚急性血栓形成。延长静脉应用肝素不能进一步改善病人的缺血并发症 ,但也不增加出血可能性。
Objective To investigate the effect of heparin on clinical prognosis after coronary stent implantation. Methods The effect of 30-day ischemic events and bleeding complications on all coronary stents in our hospital from 1998 to 2010 were retrospectively analyzed with or without venous heparin after catheter withdrawal. Results The ischemic complications in the heparin group were lower than those in the non-heparin group (P <0.05) 1.2 0%, P0.05), NQMI decreased by 65% (1.5 0% vs4.35%, P0.05), and the target vessel PTCA decreased by 78% (0.90% vs 4 .10%, P <0.05), and the rate of target vessel reinfarction decreased by 75% (0.34% vs 1.4%, P <0.01) on the 30th day. No significant difference was found between the two groups (0.6% vs 5.10%, P> 0.52). Further analysis showed no significant difference in ischemic and hemorrhagic complications between overnight heparin group and 3d heparin group (2.0% vs 3.90 %, P> 0 .1 and 5 .90% vs 7.2%, P> 0.05). Conclusion Conventional application of heparin after coronary stenting can reduce the incidence and subacute thrombosis during hospitalization and 30dQMI, NQMI, target vessel re-PTCA. Prolonged intravenous heparin does not further improve the patient’s ischemic complications but does not increase the likelihood of bleeding.