机械心脏门患者在非心脏手术前对抗凝血的决策:一项回顾性研究
Yan Liang1,2, Guiying Yang2, Hong Li2
1Department of Public Health, Chengdu Medical College, 783 Xindu Avenue, Xindu District, Chengdu, 610599, Sichuan Province, China.
Heliyon
|July 24, 2023
概括
对于接受非心脏手术的机械心脏 (MHV) 患者,如果手术前INR小于1.5.5,则停用华法林3天就足够了. 专水平也会影响凝血,应该考虑.
科学领域:
- 心脏病学 心脏病学
- 手术管理的手术管理.
- 药理学 药理学是指药理学的学科.
背景情况:
- 机械心脏门 (MHV) 需要用华法林进行抗凝治疗.
- 非心脏手术需要谨慎管理抗凝剂,以平衡出血风险和血栓事件.
- 在手术前优化华法林停止时间对于患者的安全至关重要.
研究的目的:
- 根据不同INR范围,在接受非心脏手术的MHV患者中确定停用华法林的最佳持续时间.
- 改进针对这一特定患者群体的抗凝管理策略.
- 为手术前华法林调整提供临床指导.
主要方法:
- 一个单一中心的回顾性观察研究.
- 包括121名在2012年至2021年期间接受非心脏手术的MHV成年患者.
- 与华法林停药时间和手术内出血量相关的INR水平的分析.
主要成果:
- 华法林停用≤3天导致INR为1.45,3-5天导致INR为1.15,≥5天导致INR为1.09.
- 在INR ≤1.2和INR>1.2组之间没有观察到出血的统计学上显著差异.
- 在手术期间出血量与手术前的白蛋白水平相关 (OR = 0.68).
结论:
- 对于患有MHV的患者,如果目标INR<1.5.5,那么在手术前停用华法林3天就足够了.
- 如果INR为<1.2.2,则适当停用3-5天的停用期.
- 专水平显著影响凝血,应考虑在MHV患者的手术前管理.
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