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目的比较经股静脉入径行射频消融(RFCA)术后加压包扎2h与6h的出血及栓塞并发症。方法选取因阵发性心动过速行电生理检查证实为房室结折返性心动过速和房室折返性心动过速(右侧旁路)行RFCA的患者120例,根据术后加压包扎的时间分为两组:2h组60例,6h组60例。对比两组间活化凝血时间(ACT)、术后患者不适感、局部血肿、动静脉瘘、血栓栓塞等并发症的发生率。结果 1术前两组间血小板、血凝系列和ACT无显著差异(P>0.05)。22h组术前和术后2h以及6h组术前和术后6hACT均无差异(P>0.05),但术后即刻均与术前、术后床旁(2h/6h)的ACT有显著差异(P<0.05)。另外,两组间术前、术后即刻、术后2h与6h之间均无差异(P>0.05)。两组分别有2例和1例局部淤血瘀斑发生,均无局部血肿、假性动脉瘤、动静脉瘘、血栓栓塞等发生(P>0.05)。2h组患者舒适度明显高于6h组(P<0.05)。3多因素线性相关分析发现,ACT与年龄呈正相关(r=0.315,P=0.023)。结论 RFCA术后股静脉加压包扎2h可能安全可行,无更多的出血事件发生,且病人的舒适性改善。
Objective To compare the complications of hemorrhage and embolization by pressure bandaging 2h and 6h after radiofrequency catheter ablation (RFCA). Methods A total of 120 patients with RFCA confirmed by electrophysiological examination for paroxysmal atrioventricular nodal reentrant tachycardia and atrioventricular reentrant tachycardia (right bypass) were selected according to postoperative pressure bandaging The time was divided into two groups: 60 cases in 2h group and 60 cases in 6h group. The incidence of complications such as ACT, postoperative discomfort, local hematoma, arteriovenous fistula and thromboembolism were compared between the two groups. Results 1 There was no significant difference in platelet, coagulation series and ACT between the two groups before operation (P> 0.05). There was no significant difference in ACT between preoperative and postoperative 2h and 6h in 22h group (P> 0.05), but there was a significant difference in ACT between preoperative and postoperative bedside (2h / 6h) P <0.05). In addition, there was no difference between 2h and 6h after operation (P> 0.05). There were 2 cases and 1 case of local ecchymosis in both groups. No local hematoma, pseudoaneurysm, arteriovenous fistula or thromboembolism occurred in both groups (P> 0.05). The comfort in 2h group was significantly higher than that in 6h group (P <0.05). 3multivariate linear correlation analysis found that ACT was positively correlated with age (r = 0.315, P = 0.023). Conclusion RFCA postoperative venous compression dressing 2h may be safe and feasible, no more bleeding events, and the patient’s comfort improved.