主动脉内气囊反搏的抗凝问题   总被引：2，自引：0，他引：2  

蒋晨阳  胡新央  王建安  单江 《科技通报》2004,20(5):451-454

目的　研究主动脉内气囊反搏(IABP)是否需要常规抗凝.方法　连续选择IABP病人153例,随机分组进入抗凝组(A组)71例,非抗凝组(B组)82例.抗凝组静脉给予肝素针维持aPTT于50～70s.非抗凝组无肝素针静脉维持.检测二组即刻,24h,48h以及IABP拔除后24h血小板计数,D 二聚体,纤溶酶原活化剂抑制物 1(PAI 1)和纤维蛋白降解产物(FDP)水平.观察IABP引起的肢体缺血或肢体出血等并发症、以及IABP表面的血栓情况.结果　抗凝组和非抗凝组的血小板计数和PAI 1水平于24h和48h均较本身的基础值显著下降(P<0.05).抗凝组和非抗凝组的D 二聚体和FDP水平于24h和48h均较本身的基础值显著升高(P<0.05).但二组间各个时段血小板计数,D 二聚体,PAI 1和FDP水平的比较均无显著性差异.抗凝组3例,非抗凝组2例发生一般肢体缺血.抗凝组2例大出血,8例一般出血;非抗凝组2例一般出血(P<0.05).IABP表面血栓二组均无发生.结论　IABP不需常规抗凝,抗凝不能预防IABP引起的肢体缺血.选择适当的导管经路和早期发现是预防并发症的关键.  相似文献   

Anticoagulation therapy in intra-aortic balloon counterpulsation: Does IABP really need anti-coagulation?   总被引：1，自引：0，他引：1  

蒋晨阳  赵莉莉  王建安  单江  MOHAMMOD Balgaith 《Journal of Zhejiang University. Science. B》2003,(5)

INTRODUCTIONTheintra aorticballoonpump(IABP)isthemostwidelyusedofallcirculatoryassistdevicestodayandisroutinelyusedinawiderangeofse riouscardiovascularconditions,rangingfromhe modynamicinstabilityinpatientssufferingfromcomplicationsofacutemyocardialinfarc…  相似文献   

Anticoagulation therapy in intra-aortic balloon counterpulsation: Does IABP really need anti-coagulation?     

蒋晨阳  赵莉莉  王建安  单江  MOHAMMOD Balgaith 《浙江大学学报(A卷英文版)》2003,4(5):607-611

Objective: To investigate if intra-aortic balloon pump(IABP) is contraindicated without anticoagulation therapy. Methods: Some 153 IABP patients in the King Abdulaziz Cardiac Center(KSA) were randomly assigned into two groups. Anticoagulation group (Group A) consisted of 71 patients who were given heparin intravenously with target aPTT50–70 seconds. Non-anticoagulation group (Group B) consisted of 82 patients without intravenous heparin during balloon pumping. Hematological parameters including platelet count, D-dimer, Plasminogen activator inhibitor-1 (PAI-1) and fibrinogen degradation products (FDP) were checked respectively at the point of baseline, 24 hours, 48 hours and 24 hours post IABP counterpulsation. Clot deposits on balloon surface, vascular complications from IABP including bleeding and limb ischemia were recorded. Results: Platelet count and PAI-1 level decreased at 24 hours and 48 hours in both groups (P<0.05). D-dimer dimer and FDP level increased at 24 hours and 48 hours in both groups(P<0.05), but returned to the baseline level 24 hours post IABP removal (P>0.05). Three patients in Group A and 2 patients in Group B developed minor limb ischemia (P>0.05). No major limb ischemia in either group. Two patients in Group A suffered major bleeding and required blood transfusion or surgical intervention, whereas no patient had major bleeding in Group B. Eight patients had minor bleeding in Group A, but only 2 patients in Group B (P<0.05). No clot deposit developed on IABP surface in either group. Conclusion: IABP is safe without routine anticoagulation therapy. Selecting appropriate artery approach and early detection intervention are key methods for preventing complications.  相似文献