人工机械瓣膜置换术后早期抗凝治疗的临床观察  

Clinical Results of Anticoagulant During Earlier Period after Mechanical Prosthetic Valve Replacement

作　　者：张远超[1] 喻莉[1] 张建[1] 

机构地区：[1]武汉市中心医院ICU,武汉430014

出　　处：《实用临床医学（江西）》2008年第8期54-55,共2页Practical Clinical Medicine

摘　　要：目的总结机械瓣膜置换术后早期抗凝治疗的经验和体会。方法对98例心脏机械瓣膜置换术后的患者，待心包、纵隔引流液量〈20mL／h，应用肝素作为桥接抗凝剂300-400U／h静脉泵人，维持APTT在45～50s范围内。拔除气管插管的患者开始口服华发令2．5～5mg，每日根据PT-INR值调整华发令用量，待INR值达到理想值时，停用肝素，微调华发令用量，直至测算出最合适的维持量。结果98例患者术后早期抗凝期间，无栓塞病例，少许轻微出血事件，调整用量后好转，其余患者效果良好。结论机械瓣膜置换术后，早期应用肝素＋华发令抗凝治疗安全有效。Objective To summarize the experience of anticoagulant during earlier period after mechanical pro-sthetic valve replacement. Methods Ninety-eight patients underwent valve replacement. The heparin 300-400 U/h was used after the chest drainage stopped （〈20 mL/h）. After the trachea cannula was taken away,the Warfarin （2.5-5 mg/d） was given firstly. At the same time the coagulogram was monitored. When PT-INR reached the requirement of the anticoagulation, the heparin was stopped. According to the coagulogram,the doses of Warfarin was decided. Results All patients reached the requirement of the anticoagulation. Conclusion Useing Heparin and Warfarin to anticoagulant appears to be safety and feasible early after mechanical heart valve replacement

关 键 词：机械瓣膜置换 早期 抗凝治疗 肝素 华发令 

分 类 号：R654.2[医药卫生—外科学]