目的 探討心臟機械瓣膜置換術后服用華法令的安全劑量及抗凝期間的注意事項。 方法 回顧性分析1999 年12 月至2010 年10 月皖南醫(yī)學院附屬弋磯山醫(yī)院132 例行心臟瓣膜置換術后進行華法令抗凝治療患者的臨床資料,其中男73 例,女59 例;年齡27 ~ 78 歲;術后口服華法令抗凝,隨訪3 個月~ 10 年,分析華法令應用情況及其并發(fā)癥發(fā)生情況。 結果 手術時間(240±96) min,體外循環(huán)時間(112±52) min,主動脈阻斷時間(81±23) min。全組術后出現(xiàn)皮膚紫癜2 例,死亡2 例。隨訪117 例,隨訪率90%(117/130),隨訪期間月經(jīng)期月經(jīng)量過多導致貧血4 例,血尿3 例,反復鼻衄或牙齦出血共4 例,消化道出血1 例,腦出血1 例,下肢栓塞1 例,腦梗死1 例,均治愈或好轉。 結論 心臟機械瓣膜置換術后正確服用華法令抗凝治療,及時監(jiān)測,注意各種干擾因素可以明顯降低并發(fā)癥的發(fā)生率。
引用本文: 熊克品,錢紅波,楊小龍等. 心臟機械瓣膜置換術后抗凝治療的安全性. 中國胸心血管外科臨床雜志, 2012, 19(1): 88-89. doi: 復制
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- 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.心臟瓣膜置換術后口服抗凝劑使用監(jiān)測時INR值最適范圍的探討.四川醫(yī)學, 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..