过敏性紫癜患儿行血液灌流后华法林治疗右下肢深静脉血栓的疗效观察

Therapeutic effect of warfarin on deep venous thrombosis of the right lower limb after hemoperfusion in children with henoch-schonlein purpura after hemoperfusion

目的了解过敏性紫癜儿童血液灌流后右下肢深静脉血栓形成情况,观察华法林抗凝治疗效果。方法回顾性分析2019年1月至2022年1月该院诊断为过敏性紫癜并接受血液灌流及华法林抗凝治疗的71例患儿临床资料,根据治疗过程中国际标准化比值(INR)目标值将其分为INR>1.0~1.5组、INR>1.5~2.0组及INR>2.0~3.0组,比较3组抗凝治疗时间及疗效。结果与INR>1.0~1.5组[31(21,37)d]及INR>1.5~2.0组[29(21,35)d]比较,INR>2.0~3.0组[20(12,24)d]抗凝时间更短,差异有统计学意义(H=11.533,P=0.003)。与INR>1.0~1.5组[0.52(0.36,0.65)]和INR>1.5~2.0组[0.31(0.22,0.53)]比较,INR>2.0~3.0组[0.12(0,0.24)]抗凝治疗2周后血凝块与最初血凝块比值更小,差异有统计学意义(H=44.420,P<0.001)。所有患儿均未出现血便、血尿、颅内出血等严重出血并发症。结论过敏性紫癜患儿行血液灌流后华法林治疗右下肢深静脉血栓时,INR>2.0~3.0的抗凝时间明显缩短。

Objective To investigate the deep venous thrombosis of the right lower limb after hemoperfusion in children with henoch-schonlein purpura and to observe the anticoagulant effect of warfarin.Methods The clinical data of 71 children,with henoch-schonlein purpura diagnosed in this hospital from January 2019 to January 2022 were retrospectively analyzed.According to the target value of the international normalized ratio(INR)during treatment,they were divided into three groups:INR>1.0-1.5,INR>1.5-2.0,and INR>2.0-3.0.The duration and efficacy of anticoagulant treatment in the three groups was compared.Results Compared with the INR>1.0-1.5 group[31(21,37)d]and the INR>1.5-2.0 group[29(21,35)d],the anticoagulation time of the INR>2.0-3.0 group[20(12,24)d]was shorter,the difference was statistically significant(H=11.533,P=0.003).Compared with the INR>1.0-1.5 group[0.52(0.36,0.65)]and the INR>1.5-2.0 group[0.31(0.22,0.53)],the ratio of blood clot to initial blood clot in the INR>2.0-3.0 group[0.12(0,0.24)]after anticoagulation treatment for two weeks was smaller,the difference was statistically significant(H=44.420,P<0.001).No severe bleeding complications such as bloody stool,hematuria and intracranial hemorrhage occurred in all children.Conclusion After hemoperfusion,the anticoagulation time of children with henoch-schonlein purpura(INR>2.0-3.0)is obviously shortened when warfarin is used to treat deep venous thrombosis of right lower limb.