老年肺血栓栓塞症的危险因素及华法林抗凝治疗的可行性

目的调查清华大学第一附属医院住院的老年肺血栓栓塞症患者发病的危险因素及华法林抗凝治疗的可行性。方法回顾性分析我院2007-08~2009-08间,收治的老年肺栓塞患者,探寻发病的危险因素。对确诊的患者如适合抗凝治疗则给予低分子肝素及口服华法林抗凝治疗。结果本组26例入选患者中,24例适合抗凝治疗,除1例患者在口服华法林第3 d出现痔疮出血,于第4 d停用华法林外,余23例口服华法林达6个月,均达到了消除肺栓塞的症状,预防肺栓塞复发的治疗目标。结论深静脉血栓形成是老年肺栓塞的重要危险因素。对适合抗凝治疗的老年肺栓塞患者依年龄及INR调整华法林的剂量,可以达到早期足量抗凝、预防肺栓塞复发的治疗目标,而且是安全的。

Risk Factors of Pulmonary Thromboembolism in Elderly Patients and Feasibility of Anticoagulation Therapy with Warfarin

Objective To survey risk factors of of pulmonary thromboembolism in elderly patients in Huaxin Hospital of Beijing and feasibility of anticoagulation therapy with warfarin.Methods To retrospective analysis elderly patients with pulmonary embolism in our hospital from August 2007 to August 2009,to explore risk factor.The patients who were suitable for anticoagulation therapy were given low molecular weight heparin and oral warfarin to anticoagulate.Results 24 patients fit for anticoagulant therapy in all 26 cases,except one patient stopped warfarin treatment because of hemorrhoids bleeding at the fouth day,the other 23 cases lasting 6 months treatment.Thay are up to the treatment goals of eliminating the symptoms of pulmonary embolism and preventing recurrence of pulmonary embolism.Conclusion Deep vein thrombosis is an important risk factor for pulmonary thromboembolism.Anticoagulation therapy for suitable elderly patients with pulmonary embolism,according to age and INR to adjust the dosage of warfarin,can achieve anticoagulation in early enough and obtain treatment goals of preventing the recurrence of pulmonary embolism and it is safe.