机械瓣置换患者妊娠期间抗凝治疗

doi:10.3969/j.issn.1006-7795.2015.03.005

首都医科大学学报 ›› 2015, Vol. 36 ›› Issue (3): 360-363.doi: 10.3969/j.issn.1006-7795.2015.03.005

• 心脏大血管外科领域前沿进展 • 上一篇下一篇

机械瓣置换患者妊娠期间抗凝治疗

王珺, 吕颖新, 张海波

首都医科大学附属北京安贞医院心脏外科首都医科大学心脏外科学系, 北京 100029

收稿日期:2015-03-18 出版日期:2015-06-21 发布日期:2015-06-15
通讯作者: 张海波 E-mail:zhanghb2318@163.com
基金资助:
北京市自然科学基金(7112038).

Anticoagulation therapy during pregnancy in patients with prosthetic heart valves

Wang Jun, Lyu Yingxin, Zhang Haibo

Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Department of Cardiac Surgery, Capital Medical University, Beijing 100029, China

Received:2015-03-18 Online:2015-06-21 Published:2015-06-15
Supported by:
This study was supported by Natural Science Foundation of Beijing (7112038).

摘要/Abstract

摘要：

目的机械瓣置换患者妊娠期间抗凝对母体和胎儿具有重要意义.华法林抗凝效果好,血栓栓塞发生率低,但其易致胎儿畸形、流产及死胎.肝素及低分子肝素致畸率低,但血栓栓塞的发生率高于华法林.研究表明日剂量5 mg以下时华法林对胎儿影响较小.对于血栓风险高的患者孕期全程使用华法林是可行的选择,但应慎重评估风险并结合患者本人意愿综合考量.

关键词: 机械瓣, 妊娠, 华法林, 抗凝

Abstract:

Anticoagulation therapy during pregnancy is critical to both mother with prosthetic heart valves and fetus. Warfarin offers the best maternal protection against thrombosis, but it might be associated with a high risk of fetal malformations and pregnancy loss. Heparin derivatives are associated with a reduced risk of fetal damage, but an increased risk of valve thrombosis in the mother. The risk of warfarin-related embryopathy might be dose-related.The use of warfarin throughout pregnancy for those patients at the greatest risk of thromboembolism is feasible.And the patient's preferences should also be take into account.

Key words: prosthetic heart valves, pregnancy, warfarin, anticoagulation

中图分类号:

R542

王珺, 吕颖新, 张海波. 机械瓣置换患者妊娠期间抗凝治疗[J]. 首都医科大学学报, 2015, 36(3): 360-363.

Wang Jun, Lyu Yingxin, Zhang Haibo. Anticoagulation therapy during pregnancy in patients with prosthetic heart valves[J]. Journal of Capital Medical University, 2015, 36(3): 360-363.

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机械瓣置换患者妊娠期间抗凝治疗

Anticoagulation therapy during pregnancy in patients with prosthetic heart valves

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