肝素诱导的血小板减少症患者心脏瓣膜置换术后的抗凝治疗分析

Anticoagulation therapy in a patient with heparin-induced thrombocytopenia after mechanical heart valve replacement

华法林目前仍然是人工心脏瓣膜置换术后长期口服抗凝药的唯一选择。肝素诱导的血小板减少症(HIT)是心脏瓣膜置换术后的重要并发症,而HIT患者应用华法林会增加血栓形成及肢体坏疽的风险。本文将就1例心脏瓣膜置换术后并发HIT患者的抗凝治疗探讨HIT患者应用华法林治疗的风险及应对措施。

Warfarin is still the only oral anticoagulant for long-term anticoagulation therapy in patients with heart valve replacement. Heparin induced thrombocytopenia （HIT） is a major complication after the heart valve replacement. The use of warfarin in HIT patients will increase the risk of thrombosis and limb gangrene. This article discussed the anticoagulant therapy in a patient with HIT after mechanical heart valve replacement and analyzed the risk of warfarin therapy in HIT patients and its countermeasures.