射频消融术对凝血功能的影响及低分子肝素钠的干预作用

Influence of radiofrequency catheter ablation and effect of low molecular weight heparin on coagulant system

目的:探讨射频消融术(RFCA)对凝血功能的影响及低分子肝素钠的干预作用。方法:选择62例行RFCA的阵发性室上速的患者,随机分成2组:A组32例术后不应用低分子肝素;B组30例术后6h开始皮下注射低分子肝素,连用5d。分别于术前(T0),电生理检查(EPS)后(T1),射频放电后即刻(T2),术后24h(T3),术后3d(T4),术后7d(T5)共6个时间段采静脉血做血浆D-二聚体(DD)检测。结果:2组DD自EPS至术后3d逐渐升高,术后7d下降至术前水平。术后24h、3d,B组显著低于A组。A组亚组间比较,术后3d吸烟组DD高于非吸烟组,其余各时段无差异;A组左右心导管亚组各时段无差异。结论:RFCA术(包括左右心导管操作)术后抗血小板联合抗凝治疗十分必要。

Objective：To explore the impact of radiofrequency catheter ablation （RFCA）on coagulation function and the preventive effect of low molecular weight heparin in related patients.Methods：Sixty two patients were divided into two groups randomly,32 patients of group A did not use heparin after RFCA.Thirty patients of group B were given low molecular weight heparin for 5 days after RFCA.Then D-dimer（DD）concentration were measured at six different time points：before operation,after the electrophysiologic study （EPS）,after the last RFCA immediately,at 24h,3rd and 7th day after RFCA.Results：Plasm DD in group A and B increased when EPS was finished,just the time RFCA was accomplished,and at the 24h,3rd after RFCA,restored on the 7th day after RFCA.At 24h,3rd after the procedure ,the DD levels in group B were lower than that of in group A respectively.Left-sided or right-sided ablation had no effects on the level of DD.Then DD level showed a remarkable difference between the smoking subgroup and the non-smoking subgroup in group A at 3rd day after RFCA.Conclusion：Obviously low molecular weigh heparin after RFCA can influence coagulation system and eliminate thrombolie events.