关键词: 机械瓣膜置换, 华法林, 国际标准化比值, Mechanical valve replacement, Warfarin, International normalized ratio

Abstract: Objective To study the strategy of warfarin anticoagulation and the relationship between age, gender, body weight and the coagulation dose，efficacy of warfarin, after mechanical heart valve replacement. Methods From September 2006 to September 2008, the clinical data of 192 cases received mechanical heart valve replacement and used warfarin anticoagulation therapy after operation were analyzed retrospectively. Results In this group, because of warfarin used overdose, 1 case died from intracranial bleeding and 1 case occurred extensive subcutaneous bleeding and severe nasal bleeding, 1 case occurred luminal space cerebral infraction (only single use of warfarin). 2 cases were ineffective in the only use of warfarin, but after combination with aspirin, the INR could adjust to the target range. The other cases had a good result, no severe bleeding and thrombosis were found. Conclusion Maintain dose of warfarin anticoagulation has a great individual difference after mechanical heart valve replacement. It not correlated with age, gender and body weight. To maintain anticoagulation therapy INR at 1.8 to 2.5 is appropriate, which dose not increase the risk of bleeding and thrombosis.