重庆地区心脏机械瓣膜置换术后稳定华法林抗凝剂量的探讨

目的 探讨人工机械瓣膜置换术后抗凝治疗在重庆地区人群中的治疗效果,初步建立重庆地区的换瓣患者术后抗凝治疗的临床资料库.方法 对133例重庆地区人工机械瓣膜置换术后患者采用低强度抗凝治疗标准,待其达到稳定抗凝状态且无抗凝相关并发症后,对抗凝效果进行回顾性分析,初步建立重庆地区术后抗凝标准.结果 在患者达到稳定抗凝状态后,INR值为(1.80±0.46);每日华法林剂量为(2.69±1.02)mg,不同手术组的抗凝指标均达到预期抗凝指标.重庆地区主动脉瓣置换术(AVR)的INR目标值设置为1.6(1.5～2.0),二尖瓣置换术(MVR)及双瓣置换术(DVR)的INR预计值设置为1.8(1.6～2.3)、冠状动脉搭桥术同期行MVR(MVR CABG)的INR预计值设置为2.0(1.8～2.3)、Bentall手术(人造升主动脉置换 MVR)INR预计值设置为2.2(1.8～2.5),总体INR预期值1.5～2.5.结论 本研究抗凝指标结果符合重庆地区人工机械心脏瓣膜置换术后患者的抗凝治疗强度标准.

Optimal oral anticoagulant therapy in patients with mechanical heart valve prostheses in Chongqing

Objective To define the optimal intensity of oral anticoagulant therapy in patients with mechanical heart valve prostheses in Chongqing. Methods All the 133 patients who had undergone valve replacement in our hospital were involved in this study. Warfarin therapy at an initial dose of 2.5 mg began when drainage tube was removed 24 or 48 h after operation. After oral anticoagulant therapy for 3 months, the relationship between the intensity of anticoagulant effect and dose of warfrain were analyzed. Then the...