人工心脏瓣膜替换术后抗凝治疗并发症

Anticoagulant Related Complications Following Prosthetic Heart Valve Replacement

自１９８０年至１９９２年１０月我们行人工心脏瓣膜替换术３７０例，康复出院３２９例，经３月至１２５月随访，有２例失访，共发生与抗凝治疗有关并发症１７例（５．２％或１．４８％病人－年），死亡１２例（３．６％或１．０３％病人－年），其中血栓栓塞６例（１．８２％），死亡３例（０．９１％）；抗凝出血１１例（３．３４％），死亡９例（２．７３％）。抗凝治疗并发症中出血明显多于血栓栓塞，并发症发生时间主要在术后３个月内（含术后９４天），占８９％。

Three hundred and seventy patients with prosthetic heart valve replacement between 1980～1992 were followed up for 3～125 months with lost of contact in 2.Anticoagulant related complications occurred in 17 cases(5.2% or 1.46% patient-year),resulting in 12 deaths(3.6% or 1.03% patient year)0.There were thromboembolism in 6 patients(1.82%)resulting in 3 deaths(0.91%),and hemorrhage at different sites in 11(3.34%)with 9 death(2.73%).The incidence of hemorrhage was much higher than that of thromboembolism,and most(89%)of these two complications occurred in the first 3 months after surgery.