华法令在行二尖瓣球囊成形术前抗凝作用评价

Evaluation of warfarin anticoagulant effect before percutaneous balloon mitral valvuloplasty

对１２１ 例风湿性二尖瓣狭窄病人，包括伴单纯房颤６８ 例，房颤伴左房血栓３６ 例，近期内有脑或其它部位栓塞病史者８ 例，分别给予华法令口服２ 周、４ 周、６ 周，期间根据凝血酶原时间调整用量，然后进行经皮球囊二尖瓣成形术（ＰＢＭＶ），手术成功率９８％ ，术中及术后１１ 例发生脑或其它部位栓塞，轻度出血合并症为２．８％ 。结果显示，华法令在二尖瓣狭窄合并房颤、左房血栓及近期内有栓塞史病人的抗凝治疗中疗效确切，出血合并症少，病人可安全进行经皮球囊二尖瓣扩张术。

cases with mitral stenosis of rheumatic heart disease including 68 cases with atrial fibrillation(Af) and 36 cases Af accompanding left atrial thrombi and 8 cases with cerebral emboli or other position emboli were respectively given warfarin 2 weeks ,4 weeks and 6 weeks before being treated by percutaneous balloon mitral valvuloplasty(PBMV). The doses of warfarin were regulated by prothrombin time. The rate of success of PBMV was 98%, although the complication of hyporrhea was 2.8%. There are no cerebral and other place emboli during operations and a week after operations. The results showed that the anticoagulant effect of warfarin was exact and had little complications. The patients who suffer from mitral stenosis with Af, and left atrial thrombi and history of embolism can be treated by PBMV safely after used warfarin.