CAJ | 학술논문

目的探讨心脏瓣膜置换术后的妇产科疾病患者再手术时抗凝药物的使用方法及安全性.方法 15例心脏瓣膜置换术后患者,13例均为机械瓣膜置换,一直服用华法令抗凝.患者入院后均停用华法令,改为低分子肝素皮下注射,调整PT达到或接近正常后,于术前12小时停用抗凝药物.术后12～24小时口服华法令并与低分子肝素重叠使用,3～5日后停用低分子肝素.调整药物剂量,使INR达治疗目标范围.结果 15例心脏瓣膜置换术后因妇科疾病需再次手术患者,均顺利渡过围手术期,无任何并发症出现.结论心脏瓣膜置换术后患者,再手术时只要合理调整抗凝药物种类、剂量及用法,掌握合适的抗凝强度,再次手术是安全的.
목적 탐토심장판막치환술후적부산과질병환자재수술시항응약물적사용방법 급안전성.방법 15례심장판막치환술후환자,13례균위궤계판막치환,일직복용화법령항응.환자입원후균정용화법령,개위저분자간소피하주사,조정PT체도혹접근정상후,우술전12소시정용항응약물.술후12～24소시구복화법령병여저분자간소중첩사용,3～5일후정용저분자간소.조정약물제량,사INR체치료목표범위.결과 15례심장판막치환술후인부과질병수재차수술환자,균순리도과위수술기,무임하병발증출현.결론 심장판막치환술후환자,재수술시지요합리조정항응약물충류、제량급용법,장악합괄적항응강도,재차수술시안전적.
Objective To evaluation the application and safety of anticoagulation therapy in department of gynecology and obstetrics operation after heart valve replacement. Method In the 15 patients with heart valve replacement, there were 13 patients taking Warfarin continuous for anticoagulation therapy. Warfarin be stopped and Low-molecular-weight heparin (LMWH) be changed for all patients immediately for anticoagulation therapy when admission. All anticoagulant be stopped preoperative 12 hour. Both Warfarin and LMWH had been used in postoperative 12 to 24 hour. LMWH was stopped after postoperative 3 to 5 day. The dose of Warfarin was adjusted to make INR achieve therapeutic range. Results All patients of this group had passed through the before and later period of reoperation swimmingly and none complication had been found. Conclusion The patients with heart valve replacement undergo reoperation was safety, but in the before and later period of reoperation, the dose, kind and usage must be reasonable adjusted, the intensity anticoagulation therapy must be controlled.