肝素对先天性心脏病患儿介入治疗后血小板及凝血功能的影响.pdfVIP

肝素对先天性心脏病患儿介入治疗后血小板及凝血功能的影响

摘要目的觀察肝素对先天性心脏病患儿介入治疗后血小板及凝血功能的

影响。方法回顾性分析308例行心导管介入治疗的先天性心脏病患儿的临床资

料，按照术中肝素的用量将患儿分为高剂量肝素组（148例）和低剂量肝素组

（160例）。比较手术前后及不同剂量组患儿的血小板计数、凝血五项及D-二聚

体水平。结果308例患儿，平均年龄（5.6±8.4）岁，其中0.05）。结论肝素

对先天性心脏病介入治疗后患儿的血小板及凝血功能具有不同程度的影响，但

不同剂量的肝素使用对于患儿抗血栓的有效性和出血风险的安全性并无显著的

影响。肝素在先天性心脏病介入治疗患儿中的使用安全有效。

关键词肝素；先天性心脏病；心导管介入术；凝血功能

【Abstract】ObjectiveToobservetheeffectofheparinonplateletand

coagulationfunctionafterinterventionaltherapyinchildrenwithcongenitalheart

disease.MethodsTheclinicaldataof308congenitalheartdiseasechildrentreated

withcardiaccatheterizationwereretrospectivelyanalyzed.Thechildrenweredivided

byheparindosageduringoperationintohigh-doseheparingroup（148cases）and

low-doseheparingroup（160cases）.Theplateletcount，fiveitemsofblood

coagulationandD-dimerlevelswerecomparedbeforeandafteroperationbetween

differentdosegroups.Results308childrenhadaverageageas（5.6±8.4）yearsold.

Amongthem，18.83%wereinfantsunder1yearoldand148casesweremale

children，accountingfor48.05%.Amongthechildrenenrolled，thepatentductus

arteriosuswasthemostcommon，accountingfor43.18%，whilethepulmonary

arteryandaorticvalvestenosiswererare，onlyaccountingfor2.92%.After

operation，childrenhadlowerplateletcount，fibrinogen，D-dimerlevelthanbefore

operation，andhigherprothrombintime，prothrombintime-internationalnormalized

ratio，activatedpartialthromboplastintimeandthrombintimethanbeforeoperation.

Theirdifferencewasstatisticallysignificant（P＜0.05）.Thehigh-doseheparingroup

hadhigherprothrombintimeandprothrombintime-internationalnormalizedratio

thanlow-doseheparingroup，andthedifferencewasstatisticallysignificant（P＜

0.05）.Bothgroupshadnostatisticallysignificantdifferencein