1例房颤伴十二指肠腺癌术后老年患者长期服用华法林出血的病例分析

Analysis of a case of bleeding caused by long-term irregularly oral warfarin in an elderly with atrial fibrillation and post operation of duodenal adenocarcinoma

目的 :通过分析1例老年心房颤动合并十二指肠腺癌术后长期口服华法林致出血的病例,提高临床诊断和对抗凝过程中出血风险的认识。方法 :描述患者的整个疗程,根据患者的基本情况、既往史、现病史、相关实验室检查及治疗过程分析出血原因。结果:注射维生素K1后,凝血功能恢复正常,判断出血为长期不规律使用华法林所致。结论:老年患者在长期抗凝过程中应定期监测INR,注意年龄、疾病、药物相互作用等因素对华法林疗效的影响。

Objective:To improve the clinical diagnosis and the recognition of bleeding risk in the anticoagulant process by analysis of a case of bleeding caused by long-term irregularly oral warfarin in an elderly patient with atrial fibrillation and post operation of duodenal adenocarcinoma.Methods:The patient’s entire course therapy was described and the cause of bleeding was analyzed based on her basic condition,previous history,present medical history,relevant laboratory examination and treatment process.Results:After injecting vitamin K1,her coagulation function returned to normal,judging that the bleeding was caused by long-term irregular administration of warfarin.Conclusion:Elderly patients should regularly monitor INR and pay attention to the effects of age,disease,drug interaction and other factors on the efficacy of warfarin during the long-term anticoagulation process.