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冠状动脉造影期间给予肝素对血管或外周并发症的影响:一项单盲随机对照临床试验。

Effect of Heparin Administration during Coronary Angiography on Vascular or Peripheral Complications: A Single-Blind Randomized Controlled Clinical Trial.

作者信息

Gharakhani Mohsen, Emami Farzad

机构信息

Department of Cardiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.

出版信息

Iran J Med Sci. 2013 Dec;38(4):321-6.

Abstract

BACKGROUND

Coronary angiography consists of the selective injection of contrast agents in coronary arteries. Optimal strategy for heparin administration during coronary angiography has yet to be determined. We assessed the effect of heparin administration during coronary angiography on vascular, hemorrhagic, and ischemic complications.

METHODS

Five hundred candiates for diagnostic coronary angiography (femoral approach) were randomly divided into case (intravenous Heparin [2000-3000 units]) and control (placebo) groups. Assessment included vascular complications like groin hematoma, retroperitoneal hematoma, pseudoaneurysm, active hemorrhage, cerebral ischemia, and clot formation in the catheter or the sheath during angiography. Information was obtained about the patients' age, sex, and hypertension and diabetes mellitus history. Patients with severe peripheral vascular disease, aortic stenosis, history of coagulopathy, and angiography over 30 minutes were excluded.

RESULTS

Nine patients from each group were excluded. The remaining 482 patients included 285 (59.1%) men and 197 (40.9%) women. In the case group (n=241), 7 (2.9%) patients experienced active hemorrhage at the site of angiographic puncture, 2 (0.83%) developed groin hematoma, and 8 (3.32%) experienced clot formation during angiography, while the corresponding figures for the control group (n=241) were 3 (1.24%), 2 (083%), and 13 (5.39%), respectively. No significant differences were found in hemorrhagic, ischemic, and vascular complications between the two groups.

CONCLUSION

Heparin administration during coronary angiography had no effect on clot formation as well as hemorrhagic, ischemic, and vascular complications in our patients.

TRIAL REGISTRATION NUMBER

IRCT201202199080N1.

摘要

背景

冠状动脉造影包括在冠状动脉内选择性注射造影剂。冠状动脉造影期间肝素给药的最佳策略尚未确定。我们评估了冠状动脉造影期间给予肝素对血管、出血和缺血性并发症的影响。

方法

500例拟行诊断性冠状动脉造影(经股动脉途径)的患者被随机分为病例组(静脉注射肝素[2000 - 3000单位])和对照组(安慰剂)。评估包括血管并发症,如腹股沟血肿、腹膜后血肿、假性动脉瘤、活动性出血、脑缺血以及造影期间导管或鞘内血栓形成。获取了患者的年龄、性别以及高血压和糖尿病病史等信息。排除患有严重外周血管疾病、主动脉狭窄、凝血障碍病史以及造影时间超过30分钟的患者。

结果

每组各有9例患者被排除。其余482例患者中,男性285例(59.1%),女性197例(40.9%)。病例组(n = 241)中,7例(2.9%)患者在造影穿刺部位出现活动性出血,2例(0.83%)发生腹股沟血肿,8例(3.32%)在造影期间出现血栓形成,而对照组(n = 241)相应的数字分别为3例(1.24%)、2例(0.83%)和13例(5.39%)。两组在出血、缺血和血管并发症方面未发现显著差异。

结论

在我们的患者中,冠状动脉造影期间给予肝素对血栓形成以及出血、缺血和血管并发症均无影响。

试验注册号

IRCT201202199080N1。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad3c/3838984/086687119006/ijms-38-321-g001.jpg

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