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动脉导管未闭介入封堵术后血小板减少症患者的回顾性分析

[Retrospective analysis of patients with thrombocytopenia after patent ductus arteriosus interventional occlusion].

作者信息

Liao Qi-wei, Zhang Wei-hua, Guang Xue-feng, Lu Yi-bing

机构信息

Department of Cardiology, Affiliated Yan'an Hospital of Kunming Medical University, Kunming 650051, China.

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2013 Mar;41(3):229-32.

Abstract

OBJECTIVE

To explore the risk factors of patent ductus arteriosus (PDA) patients with thrombocytopenia after PDA interventional occlusion.

METHODS

Thrombocytopenia occurred in 14 out of 350 patients underwent PDA occlusion. Age, gender, body weight, PDA size, occluder size, mean pulmonary arterial pressure, the dose of heparin, the manufacturer of occluder, residual shunt after operation were analyzed. The recovery time of different grades of thrombocytopenia was observed.

RESULTS

Multivariate logistic regression showed that the PDA size (OR = 2.238, P < 0.05), the dose of heparin (OR = 3.247, P < 0.05), residual shunt after operation (OR = 1.912, P < 0.01) were the independent risk factors of thrombocytopenia after PDA occlusion. The recovery time of mild thrombocytopenia was (7 ± 2) days without treatment. The recovery time of moderate thrombocytopenia was (12 ± 4) days with glucocorticoids treatment. The recovery time of severe thrombocytopenia was (21 ± 7) days with platelet transfusion.

CONCLUSIONS

The occluder size, dose of heparin, residual shunt are the independent risk factors of thrombocytopenia after PDA interventional occlusion. Recover time of thrombocytopenia after PDA interventional occlusion is closely related to the severity of thrombocytopenia.

摘要

目的

探讨动脉导管未闭(PDA)介入封堵术后血小板减少的危险因素。

方法

350例行PDA封堵术的患者中有14例发生血小板减少。分析患者的年龄、性别、体重、PDA大小、封堵器大小、平均肺动脉压、肝素剂量、封堵器制造商、术后残余分流情况。观察不同程度血小板减少的恢复时间。

结果

多因素Logistic回归分析显示,PDA大小(OR = 2.238,P < 0.05)、肝素剂量(OR = 3.247,P < 0.05)、术后残余分流(OR = 1.912,P < 0.01)是PDA封堵术后血小板减少的独立危险因素。轻度血小板减少未经治疗恢复时间为(7±2)天。中度血小板减少经糖皮质激素治疗恢复时间为(12±4)天。重度血小板减少经输注血小板恢复时间为(21±7)天。

结论

封堵器大小、肝素剂量、残余分流是PDA介入封堵术后血小板减少的独立危险因素。PDA介入封堵术后血小板减少的恢复时间与血小板减少的严重程度密切相关。

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