298例心脏机械瓣膜置换术后华法林抗凝治疗的安全性探讨

摘要

目的：探讨心脏机械瓣膜置换术后华法林规范抗凝治疗的安全性及用药监护的重要性。方法：回顾性分析福建医科大学附属漳州市医院（以下简称“我院”）2007年10月-2012年10月298例行心脏瓣膜置换术后进行华法林抗凝治疗患者的临床资料，观察、随访患者，记录其凝血酶原时间（ PT）及国际标准化比值（ INR），分析华法林应用及不良反应发生情况。结果：全组术后出现皮肤紫癜1例，死亡2例。随访期间皮肤紫癜1例，妊娠早期流产1例，月经期月经量过多导致贫血4例，拔牙后出血2例，脑梗死1例，出血12例，均治愈或好转。结论：心脏机械瓣膜置换术后正确服用华法林抗凝治疗，并对患者进行一系列的用药监护，可明显降低不良反应发生率，保证抗凝治疗安全。%OBJECTIVE:To evaluate the safety of warfarin anticoagulation therapy and the importance of pharmaceutical care for patients after undergoing mechanical heart valve replacement surgery. METHODS:The clinical data of a total of 298 patients receiving warfarin anticoagulation therapy after undergoing heart valve replacement surgery from October 2007 to October 2012 in Zhangzhou Municipal Hospital Affiliated to Fujian Medical University (“our hospital”) were retrospectively analyzed; the patients were observed followed-up with their prothrombin time ( PT) and international normalized ratio ( INR) and adverse drug reactions recorded. RESULTS:There were one case of skin purpura and 2 cases of death after operation. During the follow-up period, skin purpura occurred in one case, miscarriage in early pregnancy in one case, anemia caused by excessive menstrual flow during menstrual period in 4 cases, bleeding after tooth extraction in 2 cases, brain infarction in one case and hemorrhage in 12 cases, all were cured or improved. CONCLUSIONS: Taking warfarin anticoagulation therapy correctly after undergoing mechanical heart valve replacement surgery plus a range of pharmaceutical care can significantly reduce the incidence of adverse drug reactions thereby ensuring the safety of anticoagulation therapy.