CAJ | 학술논문

目的探讨心脏瓣膜置换术后应用低强度抗凝的中长期效果,讨论本院现行抗凝标准(主动脉瓣置换1.5～2.0,二尖瓣置换2.0～2.5,主动脉瓣、二尖瓣双瓣置换2.0～2.5,三尖瓣置换2.5～3.0)是否符合本地区心脏瓣膜置换术后临床抗凝要求.方法回顾性分析2009年1月至2011年12月期间就诊本院心外科行瓣膜置换治疗的681例患者临床资料.男307例,女374例;年龄21～81岁,平均(52.37±10.23)岁.患者术后抗凝治疗,记录并分析出血、血栓形成和栓塞等抗凝相关并发症的发生.结果随访患者0.5～43.0个月,完成随访602例,其中出血66例(10.96％),血栓、栓塞11例(1.83％).结论心脏瓣膜置换术后进行低强度抗凝效果可靠,本院现行抗凝标准符合本地区心脏瓣膜置换术后临床抗凝要求.
목적 탐토심장판막치환술후응용저강도항응적중장기효과,토론본원현행항응표준(주동맥판치환1.5～2.0,이첨판치환2.0～2.5,주동맥판、이첨판쌍판치환2.0～2.5,삼첨판치환2.5～3.0)시부부합본지구심장판막치환술후림상항응요구.방법 회고성분석2009년1월지2011년12월기간취진본원심외과행판막치환치료적681례환자림상자료.남307례,녀374례;년령21～81세,평균(52.37±10.23)세.환자술후항응치료,기록병분석출혈、혈전형성화전새등항응상관병발증적발생.결과 수방환자0.5～43.0개월,완성수방602례,기중출혈66례(10.96％),혈전、전새11례(1.83％).결론 심장판막치환술후진행저강도항응효과가고,본원현행항응표준부합본지구심장판막치환술후림상항응요구.
Objective To investigate the necessity of low-intensity anticoagulation standard in patients after heart valve replacement and the rationality of INR in our hospital.Methods 681 eligible candidates were anticoagulated under the current guidelines for postoperative anticoagulation therapy in our hospital(AVR 1.5-2.0,MVR 2.0-2.5,DVR 2.0-2.5,TVR 2.5-3.0).We monitored the patient 's PT regularly and analyzed the occurrence of anticoagulation-related complications,such as bleeding,thrombosis and embolism.Results 602 cases completed the follow-up.During the period of follow-up,66 patients had bleeding tendencies,the incidence of bleeding complications was 10.96％ (66/602).1 1 patients had embolism complications,the incidence of thrombotic complications was 1.83 ％ (11/602).The average of INR was 2.24± 0.68,the mean oral Warfarin dose was(3.12± 1.14) mg/d.Conclusion Our study suggest that the effect of low-intensity anticoagulation after heart valve replacement is reliable.Further more,the current anticoagulation standards of our hospital meet the requirements of postoperative clinical anticoagulant after heart valve replacement in our region.