心脏瓣膜置换术后抗凝治疗的临床研究

目的探讨心脏机械瓣膜置换术后抗凝药物华法林的应用、监测指标及并发症情况。方法回顾性分析2001年7月～2007年7月,356例心脏瓣膜置换患者术后应用华法林抗凝治疗情况及随访结果。结果术后华法林首次负荷量3.75～5 mg。随访6月～6年,平均随访2年9个月,随访INR（1.96±0.48）,华法林维持剂量（3.02±0.66）。11例有出血症状出现,1例因脑出血死亡;8例发生血栓栓塞,1例有偏瘫及失语。结论人工机械瓣膜置换术后患者正确的抗凝治疗,控制INR在1.8～2.5范围,可以减少抗凝治疗的并发症,获得满意的预防血栓栓塞和出血的效果,提高术后生活质量。

Clinical research of oral anticoagulant therapy by warfarin for the patients with mechanical heart valve prostheses

Aim To investigate the application of anticoagulation therapy after heartmechanical valve replacements,and to explore the monitoring index and complication.Methods Clinical data of 356 cases of the application of anticoagulation therapy after heart mechanical valve replacements from July 2001 to July 2007 were retrospectively analyzed.Results Follow-up has been from 6 months to 6 years,average 2 years and 9 months.INR is（1.96±0.48）,and MD of warfarin is（3.02±0.66）.11 patients were found haemorrhage,1 patient dead because of brain haemorrhage,8 patients found thromboembolia during application of anticoagulation therapy after operation.Conclusion Correct application of anticoagulation therapy after heart mechanical valve replacements,To control INR in the range of 1.8～2.5,can reduce complication of anticoagulation therapy,obtain a satisfactory result of preventing embolism or haemorrhage,improve standards of enhance life after heart mechanical valve replacement.