目的 探讨心脏机械瓣膜置换术后服用华法令的安全剂量及抗凝期间的注意事项。 方法 回顾性分析1999 年12 月至2010 年10 月皖南医学院附属弋矶山医院132 例行心脏瓣膜置换术后进行华法令抗凝治疗患者的临床资料,其中男73 例,女59 例;年龄27 ~ 78 岁;术后口服华法令抗凝,随访3 个月~ 10 年,分析华法令应用情况及其并发症发生情况。 结果 手术时间(240±96) min,体外循环时间(112±52) min,主动脉阻断时间(81±23) min。全组术后出现皮肤紫癜2 例,死亡2 例。随访117 例,随访率90%(117/130),随访期间月经期月经量过多导致贫血4 例,血尿3 例,反复鼻衄或牙龈出血共4 例,消化道出血1 例,脑出血1 例,下肢栓塞1 例,脑梗死1 例,均治愈或好转。 结论 心脏机械瓣膜置换术后正确服用华法令抗凝治疗,及时监测,注意各种干扰因素可以明显降低并发症的发生率。
Citation:
熊克品,钱红波,杨小龙等. 心脏机械瓣膜置换术后抗凝治疗的安全性. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2012, 19(1): 88-89. doi:
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Copyright © the editorial department of Chinese Journal of Clinical Thoracic and Cardiovascular Surgery of West China Medical Publisher. All rights reserved
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- 1. 王斌, 徐志云, 叶小飞.华人心脏机械瓣膜置换术后华法令抗凝强度标准的系统评价.国际心血管病杂志, 2010, 37(6):361-366.
- 2. Shannon MS, Edwards MB, Long F, et a1.Anticoagulant management of pregnancy following heart valve replacement in the United Kingdom, 1986-2002.J Heart Valve Dis, 2008, 17(5):526-532..
- 3. Thompson JL, Sundt TM, Sarano ME, et a1.In-patient international normalized ratio self-testing instruction after mechanical heart valve implantation.Ann Thorac Surg, 2008, 85(6):2046-2050..
- 4. Appelboam R, Thomas EO.Warfarin and intracranial haemorrhage.Blood Rev, 2009, 23(1):1-9..
- 5. Koertke H, Zittermann A, Wagner O, et a1.Self-management of oral anticoagulation therapy improves long-term survival in patients with mechanical heart valve replacement.Ann Thorac Surg, 2007, 83(1):24-29..
- 6. 宋郊, 李永清, 伏文雪.心脏瓣膜置换术后口服抗凝剂使用监测时INR值最适范围的探讨.四川医学, 2007, 28(3):270-271..
- 7. Miao LY, Yang J, Huang CR, et a1.Contribution of age,body weight,and CYP2C9 and VKORC 1 genotype to the anticoagulant response to warfarin:proposal for a new dosing regimen in Chinese patients.Eur J Clin Pharm, 2007, 63(12):1135-l141..
- 8. van Walraven C, Austin PC, Oake N, et a1.The effect of hospitalization on oral anticoagu1ation control:a population-based study.Thromb Res, 2007, 119(6):705-714..