抗凝药剂量不足或过量有哪些副作用 黄继江 徐州矿务集团总医院 скачать в хорошем качестве

抗凝药剂量不足或过量有哪些副作用 黄继江 徐州矿务集团总医院

抗凝药剂量不足或过量有哪些副作用 黄继江 徐州矿务集团总医院 1、抗凝不足：由于抗凝药用量不够所造成。危害：血栓形成可导致瓣膜活动障碍，瓣膜音质可有改变，甚至出现心衰等表现；脑血管栓塞可出现神经系统症状，类似中风；肢体动脉栓塞可出现肢体缺血，疼痛等症状。2、抗凝过量：由于抗凝药用量过多所造成。危害：可导致各种出血等并发症：血尿、粘膜出血如鼻出血、牙龈出血、伤口或溃疡出血、有皮肤出血点和出血性紫癜等；子宫出血，表现月经增多或异常；严重者可致脑出血。处理：出现上述情况，应及时到医院检查，调整抗凝药用量，甚至暂停用药。注意事项：由于华法林可以通过胎盘屏障，并有致畸作用，另可致出血并发症，故有生育要求的育龄妇女在怀孕的头3个月和最后3个月要用低分子肝素替代华法林。服用华法林期间必须要定期检查凝血指标，一般药物调整稳定后，也需要1－2个月复查一次凝血指标。心脏瓣膜置换术后要防止心内膜炎的发生，定期复查。 What are the side effects of insufficient or excessive dosage of anticoagulant 1. Insufficient anticoagulant: caused by insufficient dosage of anticoagulant. Hazard: thrombosis can cause valve dysfunction, The sound quality of the valve can be changed, Even appear heart failure and other manifestations; Cerebral embolism can produce neurological symptoms, Similar to stroke; Arterial embolism of the extremities may lead to limb ischemia, Pain and other symptoms. 2. Anticoagulant overdose: it is caused by too much anticoagulant. Harm: it can lead to various bleeding and other complications: hematuria, mucosal bleeding such as epistaxis, gingival bleeding, wound or ulcer bleeding, skin bleeding spots and hemorrhagic purpura, etc; Uterine bleeding, Show menstruation increase or abnormality; Severe cases may cause cerebral hemorrhage. Treatment: in case of the above situation, They should go to the hospital in time for examination, Adjust the dosage of anticoagulant, Even suspension of medication. Note: since warfarin can pass through the placental barrier, It has teratogenic effect, It can also cause bleeding complications, Therefore, low molecular weight heparin should be used to replace warfarin in the first three months and the last three months of pregnancy. Blood coagulation indexes must be checked regularly during warfarin administration, After the general drugs are adjusted and stabilized, It is also necessary to reexamine the coagulation indexes once a month or two. The occurrence of endocarditis should be prevented after heart valve replacement, Regular review.