华法林与达比加群酯在房颤射频消融围术期中的临床应用效果及安全性评价

赵世佳

[摘要] 目的 探討华法林与达比加群酯在房颤射频消融围术期的临床应用效果及安全性评价。 方法 选取2018年10月至2019年10月我院收治的接受射频消融术治疗的房颤患者76例，随机分为对照组与试验组，每组各38例。对照组患者围术期接受华法林抗凝治疗，试验组患者围术期接受达比加群酯抗凝治疗。比较两组患者的临床疗效并进行安全性评价。 结果 治疗前，两组患者的INR、TT、APTT及PT值比较，差异无统计学意义（P>0.05）;治疗1个月后的手术前，试验组患者的INR（1.50±0.25）、TT（36.04±2.22）s、APTT（41.00±2.83）s及PT（12.20±0.40）s显著高于对照组患者的INR（1.37±0.23）、TT（37.01±2.05）s、APTT（40.22±2.26）s及PT（11.20±0.35）s，差异有统计学意义（P<0.05）;手术结束后3个月，试验组患者的INR（1.71±0.28）、TT（77.61±3.35）s、APTT（55.88±4.22）s及PT（13.81±0.43）s显著高于对照组患者的INR（1.58±0.26）、TT（68.32±3.11）s、APTT（48.71±3.26）s及PT（12.88±0.40）s，差异有统计学意义（P<0.05）;两组患者治疗期间不良反应总发生率比较，试验组低于对照组，差异有统计学意义（P<0.05）。 结论 相比于华法林抗凝治疗，在房颤射频消融围术期中给予达比加群酯抗凝治疗效果更佳，能更有效抗凝，且具有较佳的治疗安全性，临床应用价值显著。

[关键词] 华法林;达比加群酯;射频消融术;房颤

[中图分类号] R541.7          [文献标识码] A          [文章编号] 1673-9701（2021）31-0016-04

[Abstract] Objective To compare the clinical application effect and safety evaluation of warfarin and dabigatran ester in perioperative radiofrequency ablation of atrial fibrillation. Methods A total of 76 patients with atrial fibrillation treated by radiofrequency ablation in our hospital from October 2018 to October 2019 were selected.They were randomly divided into the control group and the experimental group，38 cases in each group. Patients in the control group received warfarin anticoagulant therapy during perioperative period， while patients in the experimental group received dabigatran ester anticoagulant therapy during perioperative period. The clinical efficacy and safety evaluation of the two groups were compared. Results Before treatment，there were no significant differences in INR， TT， APTT and PT between the two groups（P>0.05）.INR，TT，APTT and PT were significantly higher in the experimental group [（1.50±0.25）， （36.04±2.22）s， （41.00±2.83）s and （12.20±0.40）s] than those in the control group [（1.37±0.23）， （37.01±2.05）s， （40.22±2.26）s and （11.20±0.35）s] （P<0.05）.Three months after operation， the INR， TT， APTT and PT were significantly higher in the experimental group [（1.71±0.28）， （77.61±3.35）s，（55.88±4.22）s and （13.81±0.43）s] than those in the control group[（1.58±0.26）， （68.32±3.11）s， （48.71±3.26）s and （12.88±0.40）s]（P<0.05）.There was significant difference in the total incidence of adverse reactions between the two groups during treatment，and the incidence of adverse reactions was lower in the experimental group than the control group， with statistically significant difference（P<0.05）. Conclusion Compared with warfarin anticoagulant therapy， dabigatran ester anticoagulant therapy is better and effective during radiofrequency ablation of atrial fibrillation， with better therapeutic safety and significant clinical application value.

[Key words] Warfarin; Dabigatran ester; Radiofrequency ablation; Atrial fibrillation

心房颤动属于心律失常中的一种，简称“房颤”，能够诱发心力衰竭和脑卒中等并发症，会对患者的生活质量造成严重影响[1]。心室频率控制及节律控制属于治疗房颤的主要方式，复率治疗是节律控制的主要治疗方式，复率方式包括电复律及药物复率[2]。但在药物治疗该疾病的同时，也会对其他脏器造成损害并会诱发心律失常发生。目前，临床最常用的治疗方式为经导管射频消融术，该治疗方式于1994年被首次推出应用，在降低心脑血管事件發生率及维持窦性心律转复的作用中具有显著效果。……