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1、基层医院心房颤动患者华法林抗凝治疗现状分析姜宏伟王霞［摘要］目的对基层医院心房颤动(auricularfibrillation,AF)患者接受中法林(warfarin,WF)抗凝治疗的现状和对AF患者中未使用WF抗凝的因素进行分析和探讨。方法回顾分析我院2012-06—2015-06资料完整的300例AF住院治疗患者的病历及相关资料，并着重收集AF患者个人的血管栓塞因素、用药禁忌、抗凝药使用情况和未使用WF进行抗凝的临床原因等信息。结果木研究发现在无抗凝禁忌的302例AF患者中血栓栓塞低危患者160例，其中
2、应用APR抗栓146例，合理应用抗凝药物比率占91.3%;高危患者116例，其中仅24例接受WF抗凝治疗，合理抗凝比率20.7%;未采用WF抗凝的主要原因分别为INR监测不便、患者拒绝、患者依从性差等因素，其所占的构成比率分别为26.8%、26.8%和24.4%。结论木研究发现，对低危患者人群，APR应用比率较高，除个别患者因存在应用禁忌外，均能及时给予APR抗栓治疗，且剂量合理。但高危人群需应用WF抗凝病例，WF应用不足，反映了对AF患者的抗凝治疗过程中存在着明显的问题。而对WF应用不足原因中，占比率较高
3、的却是患者的主观拒绝和担心、INR监测的不便及依从性差，今后工作中应进一步加强宣教沟通，提高AF抗凝合理用药。［关键词］AFAPRWF抗凝应用D0l:10.3760/cma.j.issn.0376-2491.2015.32.09作者单位：265600,山东蓬莱，蓬莱市人民医院AnalysisoftheSituationofWarfarinAnticoagulationTherapyinPatientswithAtrialFibrillationinGrass-rootHospitalsJiangHongwe
4、i,WangXiaAbstract:ObjectiveToanalyzethesituationof(auricularfibrillation,AF)patientsacceptingwarfarin(warfarin,WF)anticoagulanttherapyandtoexplorethereasonsofAFpatients’notacceptingWFtherapyingrass-rootshospital.MethodThemedicalrecordsandrelateddatao
5、f300casesofAFhospitalizationpatientsfromtheauthors’hospitalfromJune2012toJune2015wereretrospectivelyanalyzed.AttentionwasfocusedonthecollectingofAFpatients’personalvascularembolismfactors,contraindications,anticoagulantsandtheclinicalreasonsofA
6、FpatientswhohavenotusedWFanticoagulant.ResultThisresearchindicatethatinallthe302caseswithoutcontraindicationstoanticoagulants,therewere160thromboembolismlow-riskcases,146casesofwhomtookAPRantithrombotic,withtherationaluseofanticoagulantratioof91.3%;amongth
7、e116casesofhigh-riskpatients,only24casesacceptedWFanticoagulanttherapy,withthereasonableanticoagulantratioof20.7%;themainreasonsofnotadoptingWFanticoagulationareINRmonitoringinconvenience,patientrefusal,patientpoorcompliance,whichaccountingfor26.8%,26.8%an
8、d24.4%respectively.ConclusionThisstudyfoundthattheAPRapplicationratewashigherinpatientswithlowriskpatients,andtheAPRcouldbetreatedwithantithrombusintimewithreasonabledosage.However,thehighriskpatientsshouldbe
