论文部分内容阅读
1例62岁男性患者主动脉瓣置换术后为预防血栓联合服用阿司匹林(0.1 g,1次/d)和华法林(3.0 mg,1次/d)。用药第5天患者出现上腹部隐痛,第14天腹痛加重,第15天出现黑便。实验室检查:红细胞计数2.2×1012/L,血红蛋白65 g/L,凝血酶原时间(PT)45.9 s,国际标准化比值(INR)3.7;粪便隐血试验(++)。胃镜检查提示胃溃疡伴出血。停用阿司匹林和华法林,给予止血及对症处理。第2天患者腹痛减轻,出血消失。1周后PT降至12.8 s,INR降至1.1,恢复华法林抗凝治疗。
One 62-year-old male patient underwent prophylaxis of thrombus in combination with aspirin (0.1 g, 1 d) and warfarin (3.0 mg, 1 d) after aortic valve replacement. On the 5th day of treatment, the patient developed upper abdominal pain and increased abdominal pain on the 14th day, and melena on the 15th day. Laboratory tests: red blood cell count 2.2 × 1012 / L, hemoglobin 65 g / L, prothrombin time (PT) 45.9 s, the international standardization ratio (INR) 3.7; fecal occult blood test (++). Gastroscopy prompted gastric ulcer with bleeding. Stop aspirin and warfarin, given to stop bleeding and symptomatic treatment. Day 2 patients with abdominal pain relief, bleeding disappeared. After 1 week PT decreased to 12.8 s, INR dropped to 1.1, to restore warfarin anticoagulant therapy.