利伐沙班在起搏器围手术期应用的安全性分析

目的 观察口服利伐沙班抗凝患者起搏器围手术期囊袋出血的发生率,为优化起搏器围手术期抗凝治 疗提供证据。方法 回顾分析抗凝患者行起搏器植入术的临床资料,根据不同抗凝治疗方案将患者分为两组。A 组 (n =80)为长期口服华法林的患者,术前调整国际标准化比值(INR)至1.5~2.0,围手术期不停用华法林;B组(n = 72)患者围手术期持续口服利伐沙班。比较两组起搏器术后囊袋出血的发生率。结果 152例需抗凝治疗患者行起 搏器手术。A 组术后发生轻度囊袋出血4例,中度囊袋出血2例,重度囊袋出血1例。B 组患者72例,术后发生轻度 囊袋出血4例,中度囊袋出血1例。两组患者囊袋出血差异无统计学意义(P >0.05)。结论 围手术期持续应用利 伐沙班与华法林相比并不增加出血风险。

Safety analysis of rivaroxaban in perioperative period of pacemaker implantation

ObjectiveTo observe the incidence of perioperative pocket hemorrhage of pacemaker in patients with oral anticoagulant rivaroxaban， and to provide evidence for optimizing perioperative anticoagulation therapy. MethodsThe clinical data of patients with pacemaker implantation were retrospectively analyzed， and the patients were divided into two groups according to different anticoagulation therapies. Group A patients (n=80) received long term anticoagulant treatment with warfarin， INR adjusted to 1.5 2.0 before implantation， warfarin was not suspended in preoperative period. In group B(n=72)，patients received anticoagulant treatment with rivaroxaban constantly. The incidence of pocket hemorrhage was compared after pacemaker implantation in two groups. ResultsA total of 152 patients with anticoagulation therapies were operated pacemaker implantation. Group A showed mild pocket bleeding in 4 cases， moderate pocket bleeding in 2 cases，severe pocket bleeding in 1 case.Group B had mild pocket bleeding in 4 cases， moderate pocket bleeding in 1 case，but no severe pocket bleeding. There was no significant difference in pocket bleeding between two groups （P>0.05）. ConclusionIn perioperative period of pacemaker implantation， the constant application of rivaroxaban did not increase the risk of bleeding compared with warfarin.