华法林致肺、消化道出血1例  

Warfarin⁃induced pulmonary and digestive tract hemorrhage:a case report

作　　者：殷悦轩 刘子琦 韩艳丽[2] 郭煜 YIN Yuexuan;LIU Ziqi;HAN Yanli;GUO Yu(The second Clinical College of Shandong University of Traditional Chinese Medicine,Jinan,Shandong 250014,China;Department of Cardiology,The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan,Shandong 250001,China)

机构地区：[1]山东中医药大学第二临床医学院,山东济南250014 [2]山东中医药大学第二附属医院心血管内科,山东济南250001

出　　处：《安徽医药》2020年第9期1900-1904,共5页Anhui Medical and Pharmaceutical Journal

摘　　要：目的总结1例左心室附壁血栓病人因服用华法林不当导致肺、消化道出血的诊疗过程,探讨华法林钠片抗凝治疗过程的个体化剂量、不良反应及依从性等问题。方法回顾性分析2019年6月山东中医药大学第二附属医院心内科收治的1例因左心室附壁血栓过量服用华法林导致肺、消化道出血的病人临床资料,探讨其安全性。结果给予该病人强心利尿、纠正贫血、抗感染等对症治疗,应用维生素K1注射液(VitK1)治疗3 d后,国际标准化比值由19.07降至1.04,病人凝血功能恢复正常,出院后随访3月余,病人未再出现相关并发症。结论华法林钠片的临床应用存在较大的个体差异,容易受到诸多因素的影响,医务工作者应密切监测病人国际标准化比值,及时调整华法林的剂量,保证抗凝治疗的效用与安全。Objective To summarize the process of diagnosis and treatment of pulmonary and gastrointestinal hemorrhage in a patient with left ventricular mural thrombus due to improper administration of warfarin,and explore the individualized dosage,adverse reactions and compliance of warfarin sodium tablets during anticoagulant therapy.Methods The patient’s clinical data were analyzed retrospectively,who with pulmonary and gastrointestinal hemorrhage caused by excessive administration of warfarin due to left ventricular wall thrombus,was once treated in the department of cardiology of The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine in June 2019,and its safety was explored.Results The patient was given symptomatic treatments such as cardiotonic diuresis,anemia correction,and anti-infection.After 3 days of treatment with vitamin K1 injection(VitKl),the international normalized ratio(INR) dropped from 19.07 to 1.04,and the patient’s coagulation function returned to normal.The patient was followed up for more than 3 months after discharge,related complications have not recurred.Conclusion The clinical application of warfarin sodium tablets has large individual differences,and is easily affected by many factors.Medical workers should closely monitor the international normalized ratio(INR) of patients and adjust the dosage of warfarin in time to ensure the effectiveness and safety of anticoagulant therapy.

关 键 词：华法林/副作用 维生素K1 出血 左心室附壁血栓 国际标准化比值 

分 类 号：R969[医药卫生—药理学]