Anticoagulation and security analysis of heparin and low molecular weight heparin applied to the carotid artery after CASA / 中国现代医生

ABSTRACT

Objective To investigate anticoagulation and security of heparin and low molecular weight heparin applied to the carotid artery after CASA, to provide a reference for clinical anticoagulation. Methods From January 2010 to December 2013,120 cases of implementation of CASA surgical patients with carotid artery were selected,according to anticoagulation method they were divided into control group and observation group, control group had 54 patients, the implementation was continuous intravenous infusion of heparin for 3 days; observation group had 66 patients with sub-cutaneous low molecular weight heparin anticoagulation, one injection for 12 h, lasted for three days, before surgery,24 h,72 h after surgery,anti-Xa activity were detected in patients,activated partial thromboplastin time(APTT),pro-thrombin time (PT), complications were compared between the two groups. Results Anti-Xa activity of observation group and control group after 24 h were (1.204±0.413) IU/mL, (1.428±0.512) IU/mL, the difference was statistically significant(t=3.189,P=0.037), anti-Xa activity levels after 72 h of observation group and control group were (1.314±0.533)IU/mL,(1.684±0.687) IU/mL, the difference was statistically significant (t=4.218, P=0.030); in observation group,before surgery,24 h, 72 h after surgery APTT were(27.93±3.86)s,(37.97±5.14)s,(37.73±4.28)s, differences were statistically significant before and after surgery (t=6.453, P=0.009; t=6.449,P=0.010); in the control group,be-fore surgery,24 h,72 h after surgery APTT were(27.64±3.24)s,(38.34±4.55)s,(38.21±4.41)s,differences were statisti-cally significant before and after surgery(t=6.534,P=0.007;t=6.530,P=0.007);preoperative and 24 h,72 h postoper-ative at the same period for observation group and control group there were no significant difference(t=0.927,P=0.197;t=1.023, P=0.143; t=0.993, P=0.176); in observation group before surgery,24 h,72 h after surgery for PT compared with the control group the difference was not statistically significant (P>0.05); in observation group complication rate was 9.09%(6/66)and the control group was 7.41%(4/54)the difference was no statistically significant(χ2=1.034,P=0.114).Conclusion Low molecular weight heparin and unfractionated heparin used in carotid surgery CASA have similar anti-coagulant effect,low molecular weight heparin is slightly lower in anti-Xa activity,but it's easy to monitor and control to ensure the safety of the treatment.