(精编)【糖尿病精品课件】心房颤动抗凝治疗实践.pptVIP

华法林的平均剂量为3.19±0.69 mg（1.5-5）。华法林达到目标范围的时间，平均为23日，（18-43天） 总血栓栓塞事件（缺血性卒中合并体循环栓塞）19例（5.4%），与INR的关系 INR2 占15例，INR2-3 占4例 华法林组总出血发生率为23例6.87%，其中严重出血5例（脑出血3例，上消化道出血2例），2例导致死亡；轻微出血18例（占5.37%）。但华法林组5例严重出血的INR值均3.0。牙龈出血5例，鼻2例，皮肤粘膜瘀斑7例，血尿2例，球结膜出血1例，阴道出血1例。 Figure 1. TEEs (horizontal plane) of the left atrium and left atrial appendage (patient No. 4 of the table). Panel A shows the left atrium and appendage in a 60-year-old woman affected by mitral stenosis and aortic regurgitation. The duration of atrial fibrillation was unknown. Note the pedunculated thrombus (white arrow) at the mouth of left atrial appendage. Panel B shows the same patient after 4 weeks of warfarin. The thrombus had completely resolved. Scant spontaneous echocontrast can be seen in left atrial appendage. Atrial Thrombi Resolution After Prolonged Anticoagulation in Patients With Atrial Fibrillation* A Transesophageal Echocardiographic Study LA： 46mm LVED：55mm EF： 50mm FIGURE 1. The interaction between warfarin and amiodarone in patient 1. The daily warfarin dose andprothrombin activities are shown before and after amiodarone was commenced. Note the reduction in average daily warfarin dose required after amiodarone therapy is begun. 1027 Continued treatment with the combination of aspirin and clopidogrel after PCI appears to reduce rates of cardiovascular ischemic events.130,131 On the basis of randomized clinical trial protocols, aspirin 162 mg to 325 mg daily should be given for at least 1 month after implantation of a bare-metal stent (BMS), 3 months after implantation of a sirolimus-eluting stent (SES), and 6 months after implantation of a paclitaxel-eluting stent (PES), after which daily long-term use of aspirin should be continued indefinitely at a dose of 75 mg to 162 mg. In patients for whom there is concern about bleeding, the opinion of the writing group is that lower doses of aspirin—75 mg to 162 mg—can be used. Likewise, clopidogrel 75 mg daily should be given for a minimum