在选择性侵入性手术之前停止使用华法林
Jørn Dalsgaard Nielsen1, Thomas Steffen Hermann1
1Center of Excellence for Anticoagulant Treatment, Department of Cardiology, Copenhagen University Hospital - Bispebjerg and Frederiksberg Hospital, Denmark.
Danish medical journal
|July 2, 2025
概括
在程序之前,可能会个性化停用华法林. 了解患者的维持剂量,基线INR和目标INR,可以实现个性化的中断时间,优化抗凝管理.
科学领域:
- 药理学 药理学是指药理学的学科.
- 临床医学 临床医学
- 血栓形成的管理
背景情况:
- 华法林治疗需要在入侵性手术前进行中断.
- 目前的做法往往使用固定的中断持续时间.
- 这项研究研究了影响所需的华法林戒药时间的因素.
研究的目的:
- 为了确定华法林维持剂量和基线INR是否会影响达到目标INR所需的时间.
- 为了告知个性化的手术前华法林管理策略.
主要方法:
- 监测了120名接受自我管理华法林的患者.
- 国际规范化比率 (INR) 每天测量五天.
- 目标INR因手术出血风险 (≤1.4,≤2.5或≤3.0) 而有所不同.
主要成果:
- 华法林停止后,INR呈指数级下降,具有显著的患者间变异性.
- 较低的维持剂量 (<25 mg/周) 在第一天显示出更慢的INR下降 (9% vs 15%).
- 较低维护剂量 (113小时 vs 101小时) 的INR半衰期1日后更长.
结论:
- 术前华法林停药的持续时间可以个性化.
- 个性化的关键因素包括维持剂量,基线INR和目标INR.
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