中华胸心血管外科杂志
中華胸心血管外科雜誌
중화흉심혈관외과잡지
Chinese Journal of Thoracic and Cardiovascular Surgery
2011年
1期
8-10
,共3页
董力%刘兴会%石应康%张尔永%萧锡俊%刘丹%滕晓%任莉
董力%劉興會%石應康%張爾永%蕭錫俊%劉丹%滕曉%任莉
동력%류흥회%석응강%장이영%소석준%류단%등효%임리
心脏瓣膜假体植入%妊娠%华法林%抗凝治疗
心髒瓣膜假體植入%妊娠%華法林%抗凝治療
심장판막가체식입%임신%화법림%항응치료
Heart valve prosthesis implantation%Pregnancy%Warfarin%Anticoagulation therapy
目的 探讨心脏机械瓣膜置换术后妊娠妇女低强度抗凝治疗的方法,以及抗凝药物对孕妇和胎儿的影响.方法 随访56例心脏机械瓣膜置换术后妇女妊娠、分娩期抗凝治疗情况.结果 56例(61例次)妊娠全程均口服华法林行抗凝治疗,42例用国产华法林(3.02±0.85)mg/日,14例用进口华法林(2.84±0.57)mg/日,国际标准比值(INR)均值为1. 67±0.58.所有孕妇均无严重出血及栓塞等并发症发生,仅11例次有一般性出血现象.本组足月妊娠47例,早产7例,自然流产6例,死产(畸胎)1例;低体重儿6例.新生儿均无畸形发生.结论 心脏机械瓣膜置换术后妇女妊娠全程服用较小剂量华法林(＜5 mg/日)行低强度抗凝治疗(INR=1.5～2.0)对孕妇安全、方便,且胎儿并发症发生率较低.
目的 探討心髒機械瓣膜置換術後妊娠婦女低彊度抗凝治療的方法,以及抗凝藥物對孕婦和胎兒的影響.方法 隨訪56例心髒機械瓣膜置換術後婦女妊娠、分娩期抗凝治療情況.結果 56例(61例次)妊娠全程均口服華法林行抗凝治療,42例用國產華法林(3.02±0.85)mg/日,14例用進口華法林(2.84±0.57)mg/日,國際標準比值(INR)均值為1. 67±0.58.所有孕婦均無嚴重齣血及栓塞等併髮癥髮生,僅11例次有一般性齣血現象.本組足月妊娠47例,早產7例,自然流產6例,死產(畸胎)1例;低體重兒6例.新生兒均無畸形髮生.結論 心髒機械瓣膜置換術後婦女妊娠全程服用較小劑量華法林(＜5 mg/日)行低彊度抗凝治療(INR=1.5～2.0)對孕婦安全、方便,且胎兒併髮癥髮生率較低.
목적 탐토심장궤계판막치환술후임신부녀저강도항응치료적방법,이급항응약물대잉부화태인적영향.방법 수방56례심장궤계판막치환술후부녀임신、분면기항응치료정황.결과 56례(61례차)임신전정균구복화법림행항응치료,42례용국산화법림(3.02±0.85)mg/일,14례용진구화법림(2.84±0.57)mg/일,국제표준비치(INR)균치위1. 67±0.58.소유잉부균무엄중출혈급전새등병발증발생,부11례차유일반성출혈현상.본조족월임신47례,조산7례,자연유산6례,사산(기태)1례;저체중인6례.신생인균무기형발생.결론 심장궤계판막치환술후부녀임신전정복용교소제량화법림(＜5 mg/일)행저강도항응치료(INR=1.5～2.0)대잉부안전、방편,차태인병발증발생솔교저.
Objective To evaluate the method of low-intensity anticoagulation therapy in the pregnant women who had received mechanical heart valve replacemant, and the effects of warfarin on the pregnant women and their fetus. Methods This retrospective study involved 56 pregnant women( 61 pregnancies)who had received mechanical heart valve replacement.Their pregnant status, delivery, and anticoagulation therapy were observed and followed-up between May 1986 and November 2009 at West China Hospital of Sichuan University. Results All patients took oral anticoagulant (warfarin) throughout pregnancy. The dose of domestic warfarin was ( 3.02 ± 0.85 ) mg/d ( in 42 cases), and the dose of imported warfarin was (2.84 ± 0.57 )mg/d (in 14 cases). The mean INR value of 401 samples from patients was 1.67 ±0.58. No thromboembolism or major hemorrhagic complications occurred. Minor bleeding occurred in 11 pregnancies. Forty-seven patients had term delivery, 7 had premature birth, 6 had spontaneous abortion, and 1 had intrauterine fetal death. Six newborns were born with low birth weight (2.3 ± 0. 5 ) kg, and no abnormal fetus was observed. Conclusion The low-intensity anticoagulation therapy with warfarin (at a dose of less than 5 mg/d) and a INR target of 1.5 to 2.0 was safe and convenient for the pregnant women,who had received mechanical heart valve replacement. The abnormalities rate of fetus was low.
