机械瓣膜置换术后孕期全程口服华法令抗凝31例临床观察  

Clinical obsevvation of warfarin anticoagulation therapy in 31 pregnant woman with mechanical heart valve replacement.

作　　者：郑珞 徐霞[1] 郑志群[1] 

机构地区：[1]福建医科大学附属协和医院妇产科,福建福州350001

出　　处：《海南医学》2013年第22期3322-3324,共3页Hainan Medical Journal

摘　　要：目的探讨心脏机械瓣膜置换术后的妇女妊娠前后全程使用华法令抗凝的安全性。方法回顾性分析福建医科大学附属协和医院2002年1月至2011年12月收治的31例心脏机械瓣膜置换术后妊娠全程口服华法令抗凝治疗的孕妇并发症及围产结局。结果 31例患者中,孕早期瓣膜功能不全1例,孕晚期出现一过性血尿1例,发生一般性出血现象3例,心律不齐1例。1例因胎儿脑积水予引产,顺产5例,剖宫产25例。早产3例,足月产27例。产后出血2例。结论心脏机械瓣膜置换术后妇女在妊娠期间全程服用小剂量华法令<5 mg/d是相对安全有效的,但需大宗病例研究进一步证实。Objective To analyze the maternal and perinatal outcome in women with prostheticheart valves on the single use of perinatal warfarin anticoagulation therapy.Methods A retrospective chart review of pregnancies were performed in 31 women with mechanical valve prostheses from Jan.2002 to Dec.2011.The main outcome measures were major maternal complications and perinatal outcome.Results In the 31 patients,valve insufficiency was found in one case,general hemorrhage in three cases,hematuria in one case,arrhythmia in one case.Induction of labor was performed in one case,late pregnancy vaginal delivery in five cases,and cesarean section in twenty-five cases.Three cases were premature delivery,and twenty-seven cases were full-time children.Two cases of postpartum hemorrhage were found.Conclusion In this small sample observational study,the low-dose and low-intensity warfarin anticoagulation therapy （〈5mg/d） during pregnancy seems to be safe and feasible for both mother and fetus.Further studies are needed to validate this approach.

关 键 词：心脏机械瓣膜 妊娠 抗凝治疗 华法令 

分 类 号：R654.2[医药卫生—外科学]