依诺肝素作为一种抗凝剂治疗多发性机械二尖瓣:一例报告。

Q4 Medicine
Journal of Chest Surgery Pub Date : 2023-11-05 Epub Date: 2023-07-31 DOI:10.5090/jcs.23.031
Yo Seb Lee, Jun Seok Kim
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引用次数: 0

摘要

接受过机械瓣膜置换术的患者需要使用华法林进行抗凝治疗,以防止血栓栓塞。然而,孕妇服用华法林会增加患华法林胚胎病或中枢神经系统疾病的风险。因此,更安全的替代品,如肝素或低分子肝素注射液,被华法林所取代。然而,对这一主题的研究有限,没有大规模的研究,尤其是涉及多胎患者的研究很少。一名曾因房间隔缺损和二尖瓣狭窄接受过机械二尖瓣置换术的患者在两次妊娠期间接受了依诺肝素抗凝治疗。在确认妊娠后,每隔12小时皮下注射1 mg/kg剂量的依诺肝素代替华法林。使用抗Xa因子测定法控制依诺肝素剂量,目标范围为0.3-0.7 IU/mL。静脉注射肝素从预期分娩日期前3天开始,一直持续到分娩,之后恢复使用华法林。分娩期间未观察到并发症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Enoxaparin as an Anticoagulant in a Multipara with a Mechanical Mitral Valve: A Case Report.

Enoxaparin as an Anticoagulant in a Multipara with a Mechanical Mitral Valve: A Case Report.

Enoxaparin as an Anticoagulant in a Multipara with a Mechanical Mitral Valve: A Case Report.

Patients who have undergone mechanical valve replacement require anticoagulation therapy with warfarin to prevent thromboembolism. However, administering warfarin to pregnant patients increases their risk of warfarin embryopathy or central nervous system disorders. Consequently, safer alternatives, such as heparin or low-molecular-weight heparin injection, are substituted for warfarin. However, limited research has been conducted on this subject, with no large-scale studies and particularly few investigations involving multiparous patients. A patient who had previously undergone mechanical mitral valve replacement for atrial septal defect and mitral stenosis received anticoagulant therapy with enoxaparin during 2 pregnancies. Upon confirmation of pregnancy, warfarin was replaced with subcutaneously injected enoxaparin with a dosage of 1 mg/kg at 12-hour intervals. The enoxaparin dosage was controlled using an anti-factor Xa assay, with a target range of 0.3-0.7 IU/mL. Intravenous heparin injections were administered starting 3 days prior to the expected delivery date and were continued until delivery, after which warfarin was resumed. No complications were observed during the deliveries.

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来源期刊
Journal of Chest Surgery
Journal of Chest Surgery Medicine-Surgery
CiteScore
0.80
自引率
0.00%
发文量
76
审稿时长
7 weeks
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