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抗凝药华法林用于老年患者时应特别注意严重出血的不良反应,我们结合华法林使用不当一临床实例,分析如下。患者女,72a,5年前因患“病态窦房结综合征”安装永久性心脏起搏器,后长期服用肠溶阿斯匹林0.1 g,qd。5年中2次因半身不遂、脑梗死住院,治疗后无明显后遗症。2003年11月27日以“突发左侧肢体无力14h伴头晕”主诉入院。入院诊断:①脑梗死;②冠状动脉粥样硬化性心脏病、心房颤动、永久性心脏起搏器植入术后、心功能不全2级;③高血压病3级;④2型糖尿病。对症治疗后病情相对稳定, 查血常规正常、肝功能除Alb 26.3 g·L-1外余未见异常、PT (凝血酶原时间)12.3 s、INR(国际标准化比值)0.97。遂停
Anticoagulant Warfarin for elderly patients should pay special attention to the adverse reactions of severe bleeding, we use warfarin inappropriate clinical examples, the analysis is as follows. Female patient, 72a, 5 years ago suffering from “sick sinus syndrome” to install a permanent pacemaker, long-term use of enteric-coated aspirin 0.1 g, qd. 2 years in 5 years due to hemiplegia, cerebral infarction hospitalized, no obvious sequelae after treatment. November 27, 2003 to “sudden left limb weakness 14h with dizziness” chief complaint was admitted. Admission diagnosis: ① cerebral infarction; ② coronary atherosclerotic heart disease, atrial fibrillation, permanent cardiac pacemaker implantation, cardiac insufficiency 2; ③ hypertension 3; ④ type 2 diabetes. Symptomatic treatment after the disease is relatively stable, check the blood routine normal liver function except Alb 26.3 g · L-1 outside the exception, PT (prothrombin time) 12.3 s, INR (international normalized ratio) 0.97. Then stop