机械瓣置换患者妊娠期间抗凝治疗  

Anticoagulation therapy during pregnancy in patients with prosthetic heart valves

作　　者：王珺[1,2] 吕颖新 张海波[1,2] 

机构地区：[1]首都医科大学附属北京安贞医院心脏外科 [2]首都医科大学心脏外科学系,北京100029

出　　处：《首都医科大学学报》2015年第3期360-363,共4页Journal of Capital Medical University

基　　金：北京市自然科学基金(7112038)~~

摘　　要：目的机械瓣置换患者妊娠期间抗凝对母体和胎儿具有重要意义。华法林抗凝效果好,血栓栓塞发生率低,但其易致胎儿畸形、流产及死胎。肝素及低分子肝素致畸率低,但血栓栓塞的发生率高于华法林。研究表明日剂量5 mg以下时华法林对胎儿影响较小。对于血栓风险高的患者孕期全程使用华法林是可行的选择,但应慎重评估风险并结合患者本人意愿综合考量。Anticoagulation therapy during pregnancy is critical to both mother with prosthetic heart valves and fetus.Warfarin offers the best maternal protection against thrombosis,but it might be associated with a high risk of fetal malformations and pregnancy loss.Heparin derivatives are associated with a reduced risk of fetal damage,but an increased risk of valve thrombosis in the mother.The risk of warfarin-related embryopathy might be dose-related.The use of warfarin throughout pregnancy for those patients at the greatest risk of thromboembolism is feasible.And the patient’s preferences should also be take into account.

关 键 词：机械瓣 妊娠 华法林 抗凝 

分 类 号：R542[医药卫生—心血管疾病]