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目的回顾分析心房颤动患者的抗凝治疗状况与未抗凝的原因。方法调查资料完整的房颤患者245例。查阅病历资料,全面收集血栓栓塞高危因素、抗凝禁忌证、抗凝药物选择与用法以及未用华法令抗凝治疗的原因等信息。结果 245例房颤患者中,85.7%为慢性房颤,79.6%具有血栓栓塞高危因素。分析房颤患者未用华法令抗凝治疗的原因,24.3%有抗凝禁忌证,38.5%为医生过分担心出血并发症,和/或患者不能按要求监测国际标准化比值(INR),25.1%为阵发性房颤,尚有12.1%原因不明。治疗结果:出血并发症为0.04%,重症颅内出血占0.2%,缺血性卒中占0.2%。结论华法令在房颤患者的抗凝治疗中一般应用不足,应加强医生对华法令抗凝知识的继续教育及采用更安全有效的抗凝新药,能更好地促进房颤患者的抗凝治疗。
Objective To retrospectively analyze the anticoagulant therapy in patients with atrial fibrillation and the causes of non-anticoagulation. METHODS: A total of 245 patients with atrial fibrillation were investigated. Access to medical records, a comprehensive collection of high-risk factors for thromboembolism, anticoagulation contraindications, selection and usage of anticoagulants and warfarin did not use the reasons for the treatment of anticoagulants and other information. Results Among the 245 patients with atrial fibrillation, 85.7% were chronic atrial fibrillation and 79.6% had high risk of thromboembolism. Analysis of the causes of AF without anticoagulation with warfarin in patients with atrial fibrillation showed that 24.3% had anticoagulation contraindications, 38.5% were overly concerned with bleeding complications, and / or that patients were unable to monitor the International Normalized Ratio (INR) as required, 25.1% Paroxysmal atrial fibrillation, there are still 12.1% of the reasons unknown. Treatment outcome: Bleeding complications were 0.04%, severe intracranial hemorrhage 0.2%, and ischemic stroke 0.2%. Conclusion Warfarin is generally inadequate in the anticoagulant therapy of patients with atrial fibrillation. Doctors should further strengthen their anticoagulant therapy of warfarin in patients with atrial fibrillation by continuing education on the knowledge of warfarin and adopting safer and more effective anticoagulant drugs .