中外医疗
中外醫療
중외의료
CHINA FOREIGN MEDICAL TREATMENT
2014年
9期
15-16
,共2页
花光斌%杨蓓红%李立明%周海波%栗四方%霍洪波
花光斌%楊蓓紅%李立明%週海波%慄四方%霍洪波
화광빈%양배홍%리립명%주해파%률사방%곽홍파
心脏瓣膜置换术%华法林%抗凝%用量
心髒瓣膜置換術%華法林%抗凝%用量
심장판막치환술%화법림%항응%용량
Heart valve replacement%Warfarin%Anticoagulant%Dosage
目的:分析心脏瓣膜置换术后应用华法林抗凝治疗的效果及并发症情况,为临床选择合适的华法林用量提供参考依据。方法回顾性分析自2006年1月-2011年6月在该院行心脏瓣膜置换术的188例患者的临床资料,术后随访并记录患者使用华法林的用量和出现并发症的情况。结果所有患者均成功随访,有15例出现并发症,占8.0%,其中出血10例(5.3%),栓塞5例(2.7%);正常173例(92.0%);出血组华法林用量、凝血酶原时间(PT)和国际标准化比值(INR)均明显大于正常组和栓塞组,差异有统计学意义(P<0.05);正常组华法林平均用量为(2.0±0.6)mg/d,PT为(18.6±2.4) s,INR为(2.1±0.5)。结论心脏瓣膜置换术后应常规使用华法林进行抗凝治疗,将INR控制在1.8~2.5范围内可以满足抗凝要求并且明显减少并发症。
目的:分析心髒瓣膜置換術後應用華法林抗凝治療的效果及併髮癥情況,為臨床選擇閤適的華法林用量提供參攷依據。方法迴顧性分析自2006年1月-2011年6月在該院行心髒瓣膜置換術的188例患者的臨床資料,術後隨訪併記錄患者使用華法林的用量和齣現併髮癥的情況。結果所有患者均成功隨訪,有15例齣現併髮癥,佔8.0%,其中齣血10例(5.3%),栓塞5例(2.7%);正常173例(92.0%);齣血組華法林用量、凝血酶原時間(PT)和國際標準化比值(INR)均明顯大于正常組和栓塞組,差異有統計學意義(P<0.05);正常組華法林平均用量為(2.0±0.6)mg/d,PT為(18.6±2.4) s,INR為(2.1±0.5)。結論心髒瓣膜置換術後應常規使用華法林進行抗凝治療,將INR控製在1.8~2.5範圍內可以滿足抗凝要求併且明顯減少併髮癥。
목적:분석심장판막치환술후응용화법림항응치료적효과급병발증정황,위림상선택합괄적화법림용량제공삼고의거。방법회고성분석자2006년1월-2011년6월재해원행심장판막치환술적188례환자적림상자료,술후수방병기록환자사용화법림적용량화출현병발증적정황。결과소유환자균성공수방,유15례출현병발증,점8.0%,기중출혈10례(5.3%),전새5례(2.7%);정상173례(92.0%);출혈조화법림용량、응혈매원시간(PT)화국제표준화비치(INR)균명현대우정상조화전새조,차이유통계학의의(P<0.05);정상조화법림평균용량위(2.0±0.6)mg/d,PT위(18.6±2.4) s,INR위(2.1±0.5)。결론심장판막치환술후응상규사용화법림진행항응치료,장INR공제재1.8~2.5범위내가이만족항응요구병차명현감소병발증。
Objective To analyze the effect and complications of warfarin anticoagulant therapy after heart valve replacement so as to provide a reference for selecting appropriate warfarin dosage in clinical practice.Methods The clinical data of 188 patients with heart valve replacement admitted in our hospital from January, 2006 to June, 2011 were retrospectively analyzed. The patients were followed up postoperatively, the dosage of warfarin and postoperative complications of every patient were recorded. Results All patients were successfully followed up, and 15 cases (8.0%) developed complications, of them 10 cases (5.3%) with bleeding and 5 cases (2.7%) with embolization. 173 patients (92.0%) were normal. The warfarin dosage, prothrombin time (PT) and international normalized ratio (INR) of the hemorrhage group were significantly greater than those of the normal group and the embolism group, the differences were statistically significant (P<0.05). The average warfarin dosage of normal group was (2.0±0.6)mg/d, PT was (18.6±2.4) s and INR was (2.1±0.5). Conclusion The warfarin should be routinely used for anticoagulation after heart valve replacement, and the INR is controlled in the range of 1.8~2.5 can meet the requirement of anticoagulant and obviously reduce the complications.