支架辅助颅内动脉瘤栓塞术前应用低分子肝素的研究

The clinical application of low molecular weight heparinin intracranial aneurysms patients treated by preoperative stent-assisted embolization

目的探讨支架辅助动脉瘤栓塞术前早期应用低分子肝素的有效性和安全性。方法将90例行支架辅助动脉瘤栓塞术的患者随机分为低分子肝素(LMWH)组42例和对照组48例。LMWH组术前使用阿司匹林300mg+氯吡格雷75mg+低分子肝素2 500IU抗凝,对照组术前只使用阿司匹林300mg+氯吡格雷75mg抗凝。比较分析2组颅内出血及支架内血栓形成的发病率。结果 LMWH组与对照组围手术期发生颅内出血差异无统计学意义(P>0.05),LMWH组较对照组更少发生支架内血栓形成差异有统计学意义(P<0.05)。结论术前给予低分子肝素抗凝治疗不会增加颅内出血的风险,可减少支架内血栓形成发病率。

Objective To evaluate the safety and efficacy of the application of low molecular weight heparin（LMWH） in intracranial aneurysms patients treated by preoperative stent‐assisted embolization.Methods 45 intracranial aneurysms patients with preoperative stent‐assisted embolization were selected and randomly divided into LMWH group and the control group. The LMWH group patients were treated with aspirin（300 mg）＋ticlopidine（75 mg）＋LMWH（2500 IU）;the control group patients received aspirin（300 mg）＋ ticlopidine（75 mg）. We compared and analyzed the incidence of cerebral infarction and intracranial hemorrhage of the two groups. Results Compared with control group in perioperative period ,the incidence of intracranial hemorrhage in the LMWH group showed no significant difference（P〉0.05） ,while the incidence of stent thrombosis in LM‐WH group was lower than that in control group（P〈 0.05） .Conclusion Anticoagulation therapy with low molecular weight heparin before operation does not increase the risk of intracranial hemorrhage and can reduce the risk of cerebral infarction .