徐志懿, 关新强, 曹 烨, 高秉仁. 机械瓣膜置换术后孕期抗凝策略的研究进展[J]. 心脏杂志, 2014, 26(1): 104-107.
    引用本文: 徐志懿, 关新强, 曹 烨, 高秉仁. 机械瓣膜置换术后孕期抗凝策略的研究进展[J]. 心脏杂志, 2014, 26(1): 104-107.
    Postoperative anticoagulation therapy for pregnant women after mechanic valve replacement surgery[J]. Chinese Heart Journal, 2014, 26(1): 104-107.
    Citation: Postoperative anticoagulation therapy for pregnant women after mechanic valve replacement surgery[J]. Chinese Heart Journal, 2014, 26(1): 104-107.

    机械瓣膜置换术后孕期抗凝策略的研究进展

    Postoperative anticoagulation therapy for pregnant women after mechanic valve replacement surgery

    • 摘要: 机械瓣置换术(MVRS)是一项广泛开展的心脏手术,接受该手术的患者中,孕妇是较为特殊的群体。首选抗凝药物华法林可增加胎儿的毁损率,而替代的肝素类药品虽未减小胎儿的毁损,但可明显增加致死性血栓栓塞的发生。寄予厚望的新药达比加群酯并不能很好地预防机械瓣形成血栓,而利伐沙班及阿哌沙班的抗血栓形成效果并不比旧药表现出色,其对胎儿的副作用尚未有详细的实验室或临床证据。本文就以上问题进行了详述。

       

      Abstract: Mechanical valvular replacement surgeries represent highly operated cardiac surgeries globally. In patients who receive replacement surgeries, postoperative anticoagulation therapy for pregnant women requires special attention. Administration of warfarin, the most common anticoagulant after surgery, increases fetal damage. Instead of decreasing fetal damage, heparins used as replacement drugs dramatically increase the rate of embolism. Of the new drugs, dabigatran is confirmed to exert a poor effect in preventing thrombus from mechanical heart valves. Rivaroxaban and apixaban have achieved no better results in thrombogenesis. No clinical or experimental findings have been reported about the side effects of these new drugs to fetuses. This paper will review the research progress of the prescribed drugs in thrombus prevention.

       

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