1例74岁男性患者因既往有房颤、左房血栓，长期服用华法林0.625mg qd治疗，国际标准化比值（INR）稳定在1.22～2.01。本次因“反复咳嗽咳痰气喘六年，加重三天”入院。后使用哌拉西林钠他唑巴坦钠4.5g bid联合阿奇霉素500mg qd抗感染治疗，入院第5天因恶心呕吐加用注射用奥美拉唑钠40mg qd治疗，入院第10天查INR为5.09，停华法林，加维生素K110mg肌注，第11天INR为4.56，继续予维生素K110mg肌注，第12天开始INR稳定在1.15～1.31，第18天开始恢复使用华法林0.625g qd。%A 74-year-old male patient for always have atrial fibrillation, left atrial thrombus long-term use of warfarin 0.625 mg qd treatment, international standardization ratio(INR) stability in 1.22~2.01. This because of“repeated cough cough phlegm asthma six years, aggravating three days”to the hospital. With piperacillin sodium and sodium he azole tanzi 4.5g bid joint azithromycin 500mg qd anti-infection treatment, to the hospital for 5 days with nausea and vomiting with omeprazole sodium and mg qd treatment, admission day 10 check INR 5.09, stop warfarin, add vitamin K110mg muscle note, 11 days INR 4.56, continue to vitamin K110mg muscle note, from 12 day INR stability in 1.15~1.31, eighteenth day beginning to recover use warfarin 0.625g qd.
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