1例华法林致脑出血死亡病例分析

A Mortality Case of Cerebral Hemorrhage caused by Warfarin

华法林是最经典的口服抗凝药,常用于预防和治疗各种血栓栓塞性疾病,但过量易导致出血,其最严重的并发症是脑出血,甚至会引起死亡。2017年12月27日佛山市南海区第六人民医院收治1例华法林致脑出血死亡的女性患者,该患者有高血压病史,平素血压控制佳。住院前十余天因双下肢腘静脉血栓形成服用华法林抗凝,定期监测国际标准化比值(INR),检验值在1～3。治疗期间,曾服用中成药和醋泡生姜片。服用华法林第19天患者出现脑出血,急查凝血酶原时间(PT) 53.7 s、INR4.51。予停用华法林及止血等处理后,因患者病情过于危重,于用药第21天死亡。该病例可为今后华法林的临床合理应用提供参考。

Warfarin is the most classical oral anticoagulant drug. It is commonly used for the prevention and treatment of various type of thromboembolic diseases,but overdose of warfarin can lead to cerebral hemorrhage and death. On December 27,2017,the Sixth People's Hospital of Nanhai District in Foshan received a female patients with cerebral hemorrhage caused by warfarin. This patient had hypertension with good control of blood pressure. More than ten days before hospitalization,warfarin anticoagulation was performed due to the paraplegia of the lower limbs,and the international normalized ratio (INR) was regularly monitored. The INR was between 1 and 3. During the treatment,she had taken Chinese patent medicine and vinegar bubble ginger slices. On the 19th day of warfarin,the patient developed cerebral hemorrhage with an acute prothrombin time (PT) was 53.7 s,and INR was 4.51. After stopping the drug and symptomatic treatment,the patient died on the 21st day. It is reported to provide reference for future clinical use of warfarin rational usage.