PCI术后长期应用双联抗血小板治疗225例

目的观察PC／术后长期氯吡格雷片伍用肠溶阿司匹林双联抗血小板治疗的效果。方法对225例PCI术后患者进行1年随访观察，其中女性82例，男性143例，年龄（57．0±11．5）岁。术前常规准备，术前3d服用氯吡格雷片75mg，qd和肠溶阿司匹林片0．1g，qd；术中常规操作；术后低分子肝素5000U，q12h，IH，连用3d；出院后双联抗血小板治疗1年。于术后1个月、半年、1年复诊；如出现心前区闷痛、晕厥、牙龈出血、黑便、黄染等及时复诊。结果225例患者中多支病变66例、双支病变117例、单支病变42例。共置人支架351枚，高压后扩张67例。8例患者术前白细胞少于4．0×10^9／L，给予常规量治疗并严密观察，未出现进一步下降。个别患者出现牙龈及皮下淤斑（术后1个月、半年和1年分别为1．77％、3．11％和2．22％，P〉0．05），消化道出血2例，无颅内出血。无死亡。结论PCI术前双联抗血小板治疗（DAPT），术后长期应用安全，可起到显著抗血小板作用，对白细胞影响较小，长期应用副作用小，未出现急性冠脉事件，可改善患者生活质量。

Long-term use after PCI dual antiplatelet therapy 225 cases clinical analysis

Objective To observe the long-term clopidogrel after PCI using aspirin tablets Wu dual antiplatelet therapy treatment. Methods 225 patients of 4 years were followed up 1 year after PCI, a total income of 225 patients, female 82 cases, 143 cases were male, age （57.0＋11.5） years old. Conventional preoperative preparation, 3 days before surgery taking clopidogrel tablets 75rag, qd, enteric-coated aspirin tablets 0.1 g, qd; surgery in normal operation, postoperative low molecular weight heparin 5000 U, q12 h, I H, qd for 3 days, discharged dual antiplatelet therapy after 1 year, and after 1 month, six months, 1 year up visit. There preeordial men Tong, syncope, bleeding gums, black stools, jaundice and other timely referral. Results 66 cases of multi- vessel disease, double vessel disease in 117 patients, 42 patients with single vessel disease. A total of 351 stents, 67 patients with high spreading. 8 patients with preoperative WBC less than 4.0x109/L, given the conventional treatment and close observation volume does not appear to decline further; individual patients, and subcutaneous ecchymosis gum （after I month, six months and 1 year were 1.77%, 3.11%, 2.22%, P〉0.05）, gastrointestinal bleeding in 2 cases, no intracranial hemorrhage; no deaths. Conclusion Preoperative PCI dual antiplatelet therapy （DAPT）, postoperative long-term application security, can play a significant anti-platelet effect, little effect on white blood cells, long-term application of side effects, no acute coronary events, can improve the quality of life of patients .