重庆医学2024,Vol.53Issue(10) :1467-1471.DOI:10.3969/j.issn.1671-8348.2024.10.005

246例DVT置管溶栓患者凝血指标监测与安全评价

Monitoring and safety evaluation of coagulation indexes in 246 patients with DVT catheter directed thrombolysis

李慧琳 刘丽萍 邓佳欣
重庆医学2024,Vol.53Issue(10) :1467-1471.DOI:10.3969/j.issn.1671-8348.2024.10.005

246例DVT置管溶栓患者凝血指标监测与安全评价

Monitoring and safety evaluation of coagulation indexes in 246 patients with DVT catheter directed thrombolysis

李慧琳 1刘丽萍 2邓佳欣1
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作者信息

  • 1. 重庆医科大学附属第一医院血管外科,重庆 400016
  • 2. 重庆医科大学附属第一医院护理部,重庆 400016
  • 折叠

摘要

目的 探讨深静脉血栓(DVT)置管溶栓患者溶栓期间的凝血功能监测频次与安全性.方法 选取2014年1月至2021年12月该院因DVT置管溶栓的246例患者为研究对象,根据凝血功能监测频次分为A组(每24小时监测一次,160例)和B组(每12小时监测一次,86例).比较两组给药方案、临床疗效、出血并发症及凝血功能监测的时间变化趋势.结果 A、B组尿激酶使用剂量[240(160,320)万U vs.210(160,270)万U]和临床疗效(88.12%vs.88.37%)比较,差异无统计学意义(P>0.05).A组轻微出血发生率低于B组(15.62%vs.27.91%),差异有统计学意义(P<0.05).A、B组D-二聚体、纤维蛋白原、活化部分凝血活酶时间随时间变化趋势比较,差异无统计学差异(P>0.05).A、B组PLT随时间变化趋势比较,差异有统计学差异(P<0.05).结论 每24或12小时监测频次的凝血功能总体变化趋势具有一致性,且24 h监测一次凝血功能不会增加出血风险.

Abstract

Objective To explore the monitoring frequency and safety of coagulation function in patients with deep venous thrombosis(DVT)catheter directed thrombolysis during thrombolysis.Methods From January 2014 to December 2021,a total of 246 patients with DVT catheter directed thrombolysis in the hospital were selected as the research objects.According to the monitoring frequency of coagulation function,they were di-vided into group A(160 patients were monitored every 24 hours)and group B(86 patients were monitored every 12 hours).The medication regimen,clinical efficacy,bleeding complications and the time trend of coagu-lation function monitoring were compared between the two groups.Results There were no significant differ-ences in urokinase dosage[240(160,320)million U vs.210(160,270)million U]and the clinical efficacy(88.12%vs.88.37%)in group A and group B(P>0.05).The incidence of minor bleeding in group A was lower than that in group B(15.62%vs.27.91%),with statistical significance(P<0.05).There was no sta-tistical difference between group A and group B in the changes of D-dimer,fibrinogen and activated partial thromboplastin time with time(P>0.05).Compared with the change of platelet(PLT)with time in group A and group B,the difference was statistically significant(P<0.05).Conclusion The overall change trend of coagulation function with monitoring frequency every 24 or 12 hours is consistent,and monitoring coagulation function once every 24 hours will not increase the risk of bleeding.

关键词

深静脉血栓/置管溶栓/凝血功能/监测频率/安全性

Key words

deep venous thrombosis/catheter directed thrombolysis/coagulation function/monitoring frequency/safety

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基金项目

重庆市科卫联合医学科研项目(2021MSXM302)

重庆医科大学附属第一医院护理科研基金(HLJJ2021-28)

重庆市重点专科建设项目(0203[2023]47号202336)

出版年

2024
重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
参考文献量11
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