冠脉支架术后非心脏手术围手术期抗凝治疗分析

Assessment of Anti-Coagulative Therapy During Non-Cardiac Surgery Perioperative Period Who had Suffered Percutaneous Coronary Intervention

目的:分析经皮冠状动脉介入手术治疗术后患者行非心脏外科手术围手术期抗凝策略与心脏事件的关系。方法:回顾性分析2009年1月至2014年5月在PCI术后1年内行择期非心脏手术患者56例患者的临床资料,择期手术前予低分子肝素替代治疗,术后分为继续低分子肝素抗凝组(32例)与未抗凝组(24例),观察术后心脏事件发生情况。结果:术后1周内出现急性冠脉综合症患者中,抗凝组有1例,未抗凝组有8例,两者有统计学意义。结论:近期行PCI术的患者在行择期非心脏手术围手术期合理选择抗凝治疗方案,可以明显降低围手术期心脏事件的发生率,且并不增加术后出血的风险。

Objective To analyze the relationship between anti-coagulative strategy and major adverse cardiac events during non-cardiac surgery perioperative period who had suffered percutaneous coronary intervention.Methods The clinical data of 56 patients who underwent non-cardiac surgery after coronary stenting were analyzed. These patients were administrated with low molecular weight heparin peplacement treatment before scheduled surgeries. After surgeries,patients were divided into low molecular weight heparin anticoagulative therapy group( 32cases) and non-anticoagulative therapy group( 24 cases). The occurrence of major adverse cardiac events were evaluated. Results 1 developed ACS in 7days in anticoagulative therapy group and 8 developed in non-an ticoagulative therapy group,there was statistical difference among the 2 groups. Conclusion During non-cardiac surgery perioperative period,effective anticoagulative therapy administrated in the patients who have suffered PCI recently can obviously lower the incidence of major adverse cardiac events,and can be incapable of increasing risk of postoperative hemorrhage.