ZHANG Zhi-hong,QIN Jun,HUANG Lan,LI Long-gui,SONG Yao-ming,GENG Zhao-hua,GAO Lin-yun,LIN Chun-mei,TAO Chun-rong.Low molecular weight heparin for children after transcatheter closure of atrial septal defects: efficacy and safety[J].J Amry Med Univ (J Third Mil Med Univ),2008,30(09):858-860.
ZHANG Zhi-hong,QIN Jun,HUANG Lan,LI Long-gui,SONG Yao-ming,GENG Zhao-hua,GAO Lin-yun,LIN Chun-mei,TAO Chun-rong.Low molecular weight heparin for children after transcatheter closure of atrial septal defects: efficacy and safety[J].J Amry Med Univ (J Third Mil Med Univ),2008,30(09):858-860.DOI:
TTE)。 结果 共有43例(试验组22例,对照组21例)完成3个月随访,均无封堵器血栓形成或严重出血并发症。术前两组APTT和F1+2水平无显著性差异(P0.05),与术前相比,术后试验组APTT无显著延长(P0.05),对照组术后24 h APTT显著延长(P0.01),术后48 h恢复术前水平(P0.05)。术后两组F1+2水平与术前比较均显著升高(P0.01),但两组间比较无显著性差异(P0.05)。 结论 低分子肝素用于儿童ASD封堵术后安全、有效、简便,可以替代普通肝素。
Abstract
Objective To observe the efficacy and safety of low molecular weight heparin (LMWH) in treatment of children after transcatheter closure of atrial septal defects (ASD). Methods Totally 48 children at age of (8.4±2.1) years and weight of (22.4±7.8) kg were hospitalized in our department from July 2006 to August 2007 and diagnosed as ASD with defect of 6-24 mm by transthoracic echocardiography (TTE). They were randomized into 2 groups
LMWH group and common unfractionated heparin group (heparin group). LMWH was administered to LMWH group twice through subcutaneous injection in abdominal wall after occlusion
while unfractionated heparin was given by intervenous drop infusion for 24 h after occlusion. Activated partial thromboplastin time(APTT) and prothrombin fragment 1+2 (F1+2) levels were determined before occlusion of ASD
at 24 h and 48 h after device implantation. TTE were performed 1
3 months after occlusion of ASD. Results TTE follow-up had been performed in 43 cases. Neither thrombus on ASD occluders nor severe hemorrhage complications was found during the follow-up period. There was no significant difference between the 2 groups in APTT and F1+2 levels before occlusion. APTT of the heparin group was significantly prolonged at 24 h after occlusion (P0.01)
but returned to normal range at 48 h (P0.05)
however
such significant changes were not found in the LMWH group (P0.05). F1+2 levels of the 2 groups were significantly increased after occlusion (P0.01)
and no significant differences was seen between the 2 groups. Conclusion LMWH is a safe
effective and convenient anticoagulant in treatment of children after transcatheter closure of ASD.