一种新型心室辅助装置植入术后抗凝治疗管理
作者:
作者单位:

(1.泰达国际心血管病医院,天津 300457; 2.航天泰心科技有限公司,天津 300457)

作者简介:

通讯作者:

中图分类号:

R-33

基金项目:


Management of anticoagulant therapy after implantation of a new ventricular assist device
Author:
Affiliation:

(1. TEDA International Cardiovascular Hospital, Tianjin 300457, China.2. Rocket Heart Technology Co. Ltd, Tianjin 300457)

Fund Project:

  • 摘要
  • |
  • 图/表
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 引证文献
  • |
  • 资源附件
  • |
  • 文章评论
    摘要:

    目的 通过对左心辅助羊术后抗凝的药物管理,摸索行之有效的抗凝治疗方案?方法 6 例雄性成年绵羊,(80. 0±5. 0) kg,分别植入同一型号的左心室辅助装置(left ventricular assist device,LVAD)?术后前2 周,每日清晨采血1 次;之后,每周采晨血1 次?术后每日口服华法林,检测凝血全项,持续观察10 周,对抗凝效果做出评价?结果 6 例实验动物的生理状态下的国际标准化比率(international normalized ratio,INR)为1. 265±0. 146,活化部分凝血活酶时间(activated partial thromboplastin time,APTT) 为(41. 017 ± 12. 530) s,乳酸脱氢酶(lactatedehydrogenase,LDH)为(411±119)U/ L?术后1~3 d,应用肝素和口服华法林,控制INR 和APTT 分别为基值的1. 4和1. 7 倍?待实验动物可以平稳进食后,停止使用肝素?持续监测INR,调整华法林用量?术后2 周内,使用华法林(7. 96±5. 45)mg/ d,测得INR 为1. 89±0. 53?术后10 周内,使用华法林(11. 44±7. 80)mg/ d,测得INR 为2. 01±0. 91;LDH 为(509±92)U/ L?在研究过程中,6 例HeartCon 均未出现泵内血栓,实验动物未见消化道出血等迹象?结论 术后早期应用肝素抗凝是必要的?在不改变饮食结构的前提下,两周内基本可以制定每例个体的抗凝治疗标准?单一使用华法林,可以达到预期的抗凝效果?

    Abstract:

    Objective To determine an effective anticoagulant treatment program by the management ofanticoagulants after the implantation of a new left ventricular assist device (LVAD) in sheep. Methods Six male healthysheep weight 80±5 kg were implanted with the same type of LVAD. Blood was collected once a day in the first two weeksand once a week thereafter. The sheep were observed and evaluated for 10 weeks. Results The physiological state of thesix experimental animals: the international normalized ratio (INR) was 1. 265±0. 146; activated partial thromboplastintime (APTT) was 41. 017±12. 530 s; lactate dehydrogenase (LDH) level was 411±119 U/ L. One to three days afteroperation, the control of INR and APTT by heparin and warfarin were 1. 4 and 1. 7 times higher. Heparin was stopped whenthe animal could eat again. INR was monitored continuously and the warfarin dosage was adjusted. Two weeks afteroperation, warfarin 7. 96±5. 45 mg/ d was used and the INR was 1. 89±0. 53. Ten weeks after operation, warfarin 11. 44±7. 80 mg/ d was used, the INR was 2. 01±0. 91 and the level of LDH was 509±92 U/ L. During the study, no thrombuscaused by the pump was found, and no gastrointestinal bleeding was found in experimental animals. Conclusions It isnecessary to apply heparin early after the operation. Under the premise of not changing the diet structure, the anticoagulanttreatment standard for each individual is established within 2 weeks. The use of warfarin only can achieve the expected anticoagulant effect.

    参考文献
    相似文献
    引证文献
引用本文

刘天文,刘晓程,韩志富,刘志刚,陈铁男,李军,许剑,王帆,赵廷彪,张杰民.一种新型心室辅助装置植入术后抗凝治疗管理[J].中国比较医学杂志,2019,29(7):86~91.

复制
分享
文章指标
  • 点击次数:
  • 下载次数:
  • HTML阅读次数:
  • 引用次数:
历史
  • 收稿日期:2018-12-11
  • 最后修改日期:
  • 录用日期:
  • 在线发布日期: 2019-08-01
  • 出版日期:
自2024年1期开始,杂志参考文献改为中英文对照,具体格式要求可置下载中心查看!
关闭