中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2015年
5期
107-109,110
,共4页
孙荣艳%范正俊%冯云萍%浩一竹
孫榮豔%範正俊%馮雲萍%浩一竹
손영염%범정준%풍운평%호일죽
心房颤动%华法林%规范化抗凝治疗%CHADS2评分%老年患者
心房顫動%華法林%規範化抗凝治療%CHADS2評分%老年患者
심방전동%화법림%규범화항응치료%CHADS2평분%노년환자
Atrial fibrillation%Warfarin%Standardization anticoagulant therapy%CHADS2 risk score%Elderly patient
目的：了解老年非瓣膜性心房颤动患者规范化抗凝治疗现状，分析影响规范化抗凝治疗的因素。方法：调取2013年1-12月份曲靖市第一人民医院住院诊断为非瓣膜性心房颤动的老年患者病历，采用CHADS2评分法评价其规范化抗凝情况。结果：共入选患者161例。按照CHADS2评分法将入组患者分组，其中评分≥1患者151例中，进行规范华法林抗凝治疗的仅26例，抗凝结果11例INR在目标范围内，达到华法林抗凝目标INR值的为42.3％。结论：老年非瓣膜性心房颤动患者进行规范抗凝治疗的比例低（38.4％），其中评分≥2患者中使用华法林进行规范治疗的比例很低（19.8％），针对房颤患者规范化抗凝治疗率低的状况，分析发生原因，采取有效的干预措施，提高老年房颤患者规范化抗凝治疗率、控制率。
目的：瞭解老年非瓣膜性心房顫動患者規範化抗凝治療現狀，分析影響規範化抗凝治療的因素。方法：調取2013年1-12月份麯靖市第一人民醫院住院診斷為非瓣膜性心房顫動的老年患者病歷，採用CHADS2評分法評價其規範化抗凝情況。結果：共入選患者161例。按照CHADS2評分法將入組患者分組，其中評分≥1患者151例中，進行規範華法林抗凝治療的僅26例，抗凝結果11例INR在目標範圍內，達到華法林抗凝目標INR值的為42.3％。結論：老年非瓣膜性心房顫動患者進行規範抗凝治療的比例低（38.4％），其中評分≥2患者中使用華法林進行規範治療的比例很低（19.8％），針對房顫患者規範化抗凝治療率低的狀況，分析髮生原因，採取有效的榦預措施，提高老年房顫患者規範化抗凝治療率、控製率。
목적：료해노년비판막성심방전동환자규범화항응치료현상，분석영향규범화항응치료적인소。방법：조취2013년1-12월빈곡정시제일인민의원주원진단위비판막성심방전동적노년환자병력，채용CHADS2평분법평개기규범화항응정황。결과：공입선환자161례。안조CHADS2평분법장입조환자분조，기중평분≥1환자151례중，진행규범화법림항응치료적부26례，항응결과11례INR재목표범위내，체도화법림항응목표INR치적위42.3％。결론：노년비판막성심방전동환자진행규범항응치료적비례저（38.4％），기중평분≥2환자중사용화법림진행규범치료적비례흔저（19.8％），침대방전환자규범화항응치료솔저적상황，분석발생원인，채취유효적간예조시，제고노년방전환자규범화항응치료솔、공제솔。
Objective:To understand current the state of standardized anticoagulant therapy.In elderly patient with atrial fibrillation and analyze the factors that affect standard anticoagulant therapy,and at the same time,to make progress by the foundation of corresponding countermeasures.Method:Diagnosed nonvalvular atrial fibrillation elderly patients were history inspected for a period of 12 months(from January 2013 to December 2013)in 1st Hospital Cardiovascular Department,CHADS2 scheme method was used to stratify atrial fibrillation elderly patient and assess their risk of bleeding,the standardized anticoagulant therapy conditions were evaluated according to atrial fibrillation treatment guidelines.Result:A total of 161 patients were enrolled.According to the CHADS2 scheme,106 patients were divided into the high risk group,in which only 21 were on warfarin anticoagulant treatment.Among which 11(42.3%) had international normalized ratio(INR)in therapeutic range(2.0-3.0).Conclusion:The percentage of standard anticoagulant treatment in elderly patients with atrial fibrillation is very low(38.4%),still more,the percentage of high risk patients using warfarin standard anticoagulant treatment is even low 19.8%.Further investigation and understanding of the causes of this phenomenon will help intervene effectively and improve the standard of anticoagulant therapy in patient with atrial fibrillation.
