心房纤颤并发血栓栓塞危险因素分析.docVIP

心房纤颤并发血栓栓塞危险因素分析[摘要] 目的:探讨心房纤颤并发血栓栓塞与临床相关因素的关系。方法:对125例心房纤颤并发血栓栓塞术前行常规心脏彩色多普勒检查与各种条件调查分析。结果:年龄、房颤类型及高血压是房纤颤并发血栓栓塞的危险因素。其他因素也比较多,相对比较独立。结论:对合并高龄、CPK峰值高、心功能差等血栓栓塞危险因素的心房纤颤患者,临床医师更应该加强认识,提高临床预防和诊治水平。 [关键词] 血栓栓塞;心房纤颤;危险因素 [中图分类号] R541.7 [文献标识码]B[文章编号]1673-7210(2010)05(c)-142-02 Analysis on the factor of atrial fibrillation complicated with thromboembolism risk LIU Yang (Medicine of Qingxi Hospital,Dongguan City ,Dongguan523660) [Abstract] Objective: To evaluate the atrial fibrillation complicated with thromboembolism-related factors and clinical relationship. Methods: 125 patients of preoperative atrial fibrillation complicated with thromboembolism by conventional color Doppler examination with a variety of cardiac conditions were analyzed. Results: The age, type of atrial fibrillation and hypertension were complicated as the fibrillation thromboembolism risk factors. Other factorswere more relatively independent. Conclusion: With regard to the advanced age of the merger, CPK peak high and poor cardiac function of risk factors for thromboembolism in patients with atrial fibrillation, clinicians should promote awareness, improve the level of clinical prevention, diagnosis and treatment. [Key words] Thromboembolism; Atrial fibrillation; Risk factors 心房纤颤是临床十分常见的心律失常之一,可引起严重的并发症,比如会增加心衰、血栓栓塞、死亡的发生几率,其中血栓栓塞是其严重并发症。笔者对我院近4年来收治的125例心房纤颤患者进行临床分析,以探讨心房纤颤并发血栓栓塞的危险因素,试图为防治心房纤颤患者的血栓栓塞提供参考依据。现报道如下: 1资料与方法 1.1 一般资料 选择2005~2009年在我院住院治疗并获随访的125例房颤患者。其中,男65例,女60例;年龄34～82岁,平均64.5岁。所有入选的非瓣膜病慢性心房颤动患者均严格按照欧洲心脏病学会(ESC)和北美心脏起搏和电生理学会(NASPE)《关于房颤的命名和分类方法(2003)》的标准。纳入标准:①所有入选的非瓣膜病慢性心房颤动患者,均经静息心电图或动态心电图等证实。②无风湿性心脏病及退行性瓣膜病病史、体征和超声心动图表现。排除标准:①经超声心动图检查证实有心脏瓣膜性疾病;②痴呆或精神病,难以提供准确、详尽的病史;③严重肝肾功能衰竭、恶性肿瘤等预期寿命≤12个月。 1.2 调查与心电图监护方法 通过电话、信访、门诊或医生家访等方式进行随访调查,调查内容包括:年龄、性别、地址、房颤类型、持续时间、伴随疾病、左房及左室大小、心功能状况、脂蛋白及纤维蛋白原水平、药物干预情况、服药期间有无出血并发症、停药原因、有无缺血性脑卒中及生存状况。分组:根据患者治疗情况将患者分为:抗栓治疗组65例、未抗栓治疗组60例。同时全部患者入院后常规心电图监护5~7 d,并于入院后前3 d每天至少描记心电图1次,对血栓栓塞部位进行定位诊断,下壁、下壁+后壁、下壁+侧壁、下壁+右室梗死归入下壁梗死