【摘要】 目的　研究我国南方地区人工机械瓣膜置换术后行低强度抗凝的可行性及安全强度。方法　75例置换人工机械瓣膜的患者按国际标准化比值(INR)分为A、B、C 3组。术后定时分别检测其凝血酶原时间(PT)及INR、D 二聚体浓度、抗凝血酶Ⅲ活性(AT Ⅲ:C) ,并定时监测术后出血及血栓形成的发生率。结果　机械瓣膜置换术后,INR控制于1.6～2 .5范围,可保持D 二聚体浓度、AT Ⅲ:C与对照组差异无统计学意义(P >0 .0 5 )。2 5 5人次INR控制1.6～2 .5之间,3组均未出现血栓形成,有16人次轻微出血,其中A组有4人次(4 /15 5 ,2 .5 % ) ;B组有5人次(5 /70 ,7.1% ) ;C组有7人次(7/3 0 ,2 3 .3 % ) ,明显高于A、B两组(P <0 .0 1)。结论　我国南方地区人工机械瓣膜置换术后低强度抗凝是可行的,INR控制在1.6～2 .5范围较安全。更多还原

【Abstract】 Objective To evaluate the possibility and safety bounds of low intense anti-coagulation therapy after replacement of prosthetic mechanical valve.Methods Seven-five cases undergoing replacement of prosthetic mechanical valve were divided into groups A,B and C according to International Normalized Ratio (INR).They were examined for PT,INR,D-dimer and antithrombin Ⅲ (AT-Ⅲ) punctually.Hemorrhage and thrombo-embolic were observed simultaneously.Results INR was controlled between 1.6 to 2.5 after replacement of prosthetic mechanical valve.There was no significant difference ( P > 0.05) in D-dimer,AT-Ⅲ between observation groups and controlled group.When INR was controlled between 1.6 to 2.5 in 255 cases·times,there were 16 cases of mild hemorrhage,but no thrombo-embolism occurred in all groups.Of these mild hemorrhage patients,there were 4 in group A (4/155, 2.5%), 5 in group B (5/70, 7.1%), and 7 in group C (7/30, 23.3%). Conclusion It is acceptable to practice low intense anti-coagulation therapy after replacement of prosthetic mechanical valve.It is safe to control INR between 1.6 to 2.5 after the operation.更多还原