冠脉腔内支架置入术后联合抗凝的探讨

Study of associated anticoagulation after stenting implantation in patients with coronary artery disease

目的 :评价冠脉腔内支架置入术后低分子肝素、噻氯匹定和阿司匹林联合抗凝的效果和安全性。方法 :12 1例行经皮冠状动脉腔内支架置入术的患者 ,分成择期组 86例 ,不稳定心绞痛低分子肝素抗凝不佳需行急诊支架置入术者为急诊组 1共 15例 ,急性心肌梗死 2 0例直接支架置入术为急诊组 2。急诊组l术前不停用低分子肝素 ,术后低分子肝素 0 .4ml,每 12h1次共 7d ;噻氯匹定 0 .2 5g/次 ,每天两次和阿司匹林 0 .1g/d ,顿服共 1月联合抗凝。结果 :三组术后无l例出现急性、亚急性闭塞 ,无严重的出血并发症 ,一周内无心绞痛发作。结论 :冠脉腔内支架置入术后低分子肝素、噻氯匹定和阿司匹林联合抗凝可预防急性、亚急性闭塞 ,未增加术后出血的发生 。

Objective: To explore effect and safety of associated with low-molecular-weight heparin(Fraxiparine) , Ticolopdine and aspirin(Bamyl) in anticoagulation after stenting implantation in patients with coronary artery disease. Methods: From January 2000 to December 2001, 121 patients after stenting implantation were studied. They were divided into 3 groups: chose period group: 86 patients with unstable coronary artery disease, emergency group l: 15 patients with unstable coronary artery disease underwent anticoagulation became no better, that had to be primary stenting implantation; emergency group 2: 20 acute myocardial infarction underwent primary stenting implantation. Emergency group l did not stop using low-molecular-weight heparin before the technique, and after the technique all patients underwent Fraxipine, 0.4ml, once 12 hours during a 7-day period;Ticlopidine, 0.25g, twice daily and Bamyl, 0.1g, once daily during al-month period. Results: There was no one with acute and subacute emphraxis , severe bleeding in three groups. There were symptoms of angina in all patients during a 7-day period. Conclusion: Associated with low-molecular-weight heparin(Fraxiparine) , Ticlopidine and aspirin (Bamyl) in anticoagulation after stenting implantation in patients with coronary artery disease, that prevent them from undergoing acute and subactue emphraxis. It add not to hemorrhagic occurrence. It is effective and safe.