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目的:评价以口服肠溶阿司匹林片、氯吡格雷片及静脉滴注肝素的抗血栓方案,对老年患者冠状动脉支架术后应用的有效性及安全性。方法:145例患者,其中≥70岁的高龄组患者63例,<70岁的非高龄组患者82例,均在冠状动脉支架术后使用上述的抗血栓方案。观察出血的并发症及冠状动脉内急性或亚急性血栓形成的发生率。结果:高龄组中发生皮下及尿路出血各2例(3.2%),非高龄组各3例(3.7%),2组间均差异无统计学意义(P>0.05)。高龄与非高龄组中均有1例(1.7%,1.2%)发生冠状动脉内血栓形成,差异也无统计学意义(P>0.05)。结论:只要严密观察及控制抗血栓指标,对高龄患者冠状动脉支架术后口服肠溶阿司匹林片、氯吡格雷片及静脉滴注肝素的抗血栓方案是安全有效的。
OBJECTIVE: To evaluate the effectiveness and safety of oral enteric-coated aspirin tablets, clopidogrel tablets and intravenous anticoagulant heparin in the elderly patients after coronary stenting. Methods: A total of 145 patients, including 63 elderly patients aged 70 years or older and 82 non-elderly patients aged <70 years, were enrolled in the anti-thrombotic regimen after coronary stenting. Hemorrhagic complications and the incidence of acute or sub-acute coronary thromboembolism were observed. Results: Two cases (3.2%) of subcutaneous and urinary tract hemorrhage occurred in the elderly group and three cases (3.7%) in the non-elderly group, respectively. There was no significant difference between the two groups (P> 0.05). Coronary thrombosis occurred in 1 (1.7%, 1.2%) of the elderly and non-elderly patients, with no significant difference (P> 0.05). Conclusion: As long as the close observation and control of antithrombotic indexes, it is safe and effective for the elderly patients to take oral enteric-coated aspirin tablets, clopidogrel tablets and intravenous heparin anticoagulation after coronary stenting.