摘要
目的 探讨心脏瓣膜术后患者口服华法林抗凝指标凝血酶原时间国际标准化比值(PT-INR)的监测策略,为瓣膜外科术后患者寻求合适的随访监测手段。方法 选择2019年1~3月广东省人民医院心外科成人二区接受心脏瓣膜外科手术并需要口服华法林抗凝治疗的患者107例。同一患者根据抗凝监测手段不同分为两组:对照组即抽取枸橼酸钠静脉抗凝血送至医院检验科,应用法国思塔高公司生产STAGO-E监测仪器得出PT-INR结果;实验组即取两滴指尖末梢全血,应用深圳qLabsPT-INR(Q1/Q3型号)凝血检测仪得出PT-INR结果。对两组抗凝监测结果 PT-INR进行相关性、偏差分析及探讨两种监测手段的优劣性。结果 两种凝血监测仪之间显示了良好的相关性,相关系数(R)均>0.9,其结果偏差较小,且符合心脏机械瓣膜置换术后抗凝治疗窗范围内INR为1.5~2.5,具有较好的一致性和稳定性。便携式深圳qLabs凝血检测仪,因操作方便、得出结果快捷及经济效应明显等优点,容易被接受。结论 便携式深圳qLabs凝血检测仪对比医院大型仪器相关性良好,尤其适合应用在心脏机械瓣膜置换术后口服华法林抗凝治疗要求治疗窗内的患者,为瓣膜术后患者抗凝随访寻求可行性新型管理模式。
Objective To explore the monitoring strategy of Warfarin anticoagulant index prothrombin time-international normalized ratio(PT-INR)in patients after cardiac valve surgery,and to find a suitable follow-up monitoring method for patients after valvular surgery.Methods One hundred and seven patients undergoing cardiac valve surgery and requiring oral Warfarin anticoagulant therapy in Adult Area Two of Cardiac Surgery of Guangdong Provincial People′s Hospital were selected in this study from January to March 2019.According to the different anticoagulant monitoring methods,the same patient was divided into two groups:control group was taken Sodium Citrate intravenous anticoagulant and sent to the hospital laboratory,and the PT-INR results were obtained by using STAGO-E monitoring instrument produced by Sitagao Company of France,and two drops of whole blood from fingertip endings were taken from experimental group,and PT-INR results were obtained by Shenzhen qLabsPT-INR(Q1/Q3 model)coagulation detector.The correlation and deviation analysis of PT-INR between two groups of anticoagulant monitoring results were carried out,and the advantages and disadvantages of the two monitoring methods were discussed.Results There was a good correlation between the two blood coagulation monitoring instruments,the correlation coefficient R was more than 0.9,and the deviation of the results was small.It was consistent with INR(1.5-2.5)in the anticoagulation window after mechanical valvular replacement,and had good consistency and stability.The portable Shenzhen qLabs coagulation detector was easy to accept because of its convenient operation,quick result and obvious economic effect.Conclusion The portable Shenzhen qLabs blood coagulation detector has a good correlation with the large-scale instruments in the hospital,and is especially suitable for patients who are required to be treated within the treatment window after cardiac mechanical valve replacement.
作者
彭晓鹏
周成斌
黄劲松
吴敏
PENG Xiaopeng;ZHOU Chengbin;HUANG Jinsong;WU Min(Adult Area Two of Cardiac Surgery,Guangdong Cardiovascular Institute Guangdong Provincial People′s Hospital Guangdong Academy of Medical Sciences Guangdong Provincial Key Laboratory of South China Structural Heart Disease,Guangdong Province,Guangzhou 510080,China;Cardial Surgery Cardiovascular Center,Dongguan Kanghua Hospital,Guangdong Province,Dongguan 523000,China)
出处
《中国医药导报》
CAS
2019年第35期52-56,共5页
China Medical Herald
基金
广东省省级科技计划项目(2017B090904034、2017B030314109)
关键词
抗凝监测
凝血分析仪
随访管理模式
心脏瓣膜外科术后
自我检测
Anticoagulation monitoring
Coagulation analyzer
Follow-up management model
Cardiac valve surgery
Self-detection
