摘要
目的比较达比加群酯和华法林用于阵发性心房颤动(简称房颤)患者导管消融围手术期的疗效和安全性。方法入选本科行房颤导管消融手术的阵发性房颤患者60例,随机分为华法林组与达比加群酯组,每组30例。记录患者的一般情况,评估栓塞和出血风险。两组患者分别参照指南给予术前、术中及术后的抗凝治疗。观察患者的围手术期死亡、出血和栓塞事件、不良反应和住院时间。结果两组患者的年龄、性别组成、伴随疾病及栓塞危险评分无显著差异。两组患者无围手术期死亡与血栓栓塞事件。华法林组的围手术期出血事件明显多于达比加群酯组[13.3%(4/30)vs 3.3%(1/30),P<0.05],大出血1例,发生于华法林组,为穿刺部位血肿导致输血。术后住院时间华法林组明显长于达比加群酯组[(4.1±1.7)d vs(2.1±0.3)d,P<0.05]。达比加群酯组常见的不良反应是腹痛,有5例(16.7%)出现,仅1例不能耐受而改服华法林。结论房颤导管消融围手术期应用达比加群酯,可能缩短住院时间,减少出血事件,较多见的不良反应是轻微的胃肠道症状。
Objective To compare the safety and efficacy of dabigatran versus warfarin in paroxysmal atrial fibrillation（AF） patients undergoing catheter ablation. Methods Sixty patients with paroxysmal AF who underwent AF ablation in our hospital were selected. The patients were randomized to treatment with warfarin or dabigatran. There were 30 cases in each group. Death, bleeding and thromboembolic events, drug adverse reactions and the hospitalization time were observed. Results There was no significant difference between two groups in age, gen- der composition, concomitant diseases and embolism score. No deaths and thromboembolic events occurred in all of the patients. The bleeding events of warfarin group were much more than those of dabigatran group [13.3 % （4/30） vs 3.3 % （1/30）,P〈0. 051. One case of hemorrhoea occurred in warfarin group, as the hematoma of thigh inducing blood transfusion. The hospitalization time of warfarin group was significantly longer than that of dabigatran group [（4.1±1.7）d vs （2.1±0.3）d,P〈0. 051. Five cases （16.7%） in dabigatran group had stomachache and only 1 of them changed to warfarin. Conclusion Compared to warfarin, dabigatran could shorten the hospitalization time and reduce the occurrence of bleeding events rate for the AF patients undergoing catheter ablation. The common ad- verse reactions are mild gastrointestinal symptoms. [Chinese Journal of Cardiac Pacing and Electrophysiology, 2016,30（2） ： 123 - 126]
出处
《中国心脏起搏与心电生理杂志》
2016年第2期123-126,共4页
Chinese Journal of Cardiac Pacing and Electrophysiology
