摘要
目的总结风湿性心脏瓣膜病瓣膜置换术后华法林抗凝治疗的监测与护理要点。方法以我院心胸外科306例瓣膜置换术后口服华法林患者为研究对象,对其进行护理干预,监测凝血酶原时间(PT)及其国际标准化比率(INR),观察治疗效果、不良反应。结果经过规范的抗凝治疗和护理,92.8%的患者的INR控制在适宜范围内,住院期间仅有4%的患者发生因抗凝治疗导致出血或血栓形成及栓塞等并发症。结论华法林治疗窗窄,剂量个体差异大,抗凝不足可导致血栓,抗凝过量则有出血甚至致死的风险。加强对口服华法林患者的护理干预及健康教育,可以提高患者用药的依从性,达到既有效抗凝,又不产生明显并发症的目的。
Objective To summarize the key points on monitoring and nursing of warfarin anticoagulation therapy for patients after cardiac valve replacement. Methods 306 patients administered oral warfarin after cardiac valve replacement in department of cardiothoracic surgery were taken as study subjects. Prothrombin time （PT） and international standardization ratio （INR） were monitored, the treatment effect and adverse reactions were observed. Results After treatment and nursing of anticoagulation,92. 8 % of patients achieved anticoagulation therapy within therapeutic targets ,only 4% of the patients had bleeding or thrombosis and embolism caused by anticoagulation complications during hospitalization. Conclusion Underanticoagulation are vulnerable to venous thrombotic events, while overanticoagulation is at risk for bleeding or even death because warfarin is a drug with a narrow therapeutic index and large interindividual variability. Strengthening nursing intervention and health education in patients administered oral warfarin can improve the patients medication compliance, achieve effective anticoagulation and reduce significant complications.
出处
《实用药物与临床》
CAS
2014年第8期1067-1069,共3页
Practical Pharmacy and Clinical Remedies
关键词
华法林
抗凝
临床护理
Warfarin
Anticoagulation
Clinical nursing
