劉月英

【摘要】 目的：探討吲哚布芬對(duì)比華法林用于房顫患者抗凝治療的效果和護(hù)理分析。方法：選擇2016年2月-2017年7月在福建醫(yī)科大學(xué)附屬第二醫(yī)院收治的137例房顫患者，隨機(jī)分為研究組（70例）和對(duì)照組（67例）。兩組均給予常規(guī)護(hù)理，對(duì)照組給予口服華法林5 mg，研究組給予口服吲哚布芬片。比較兩組患者血漿中D-二聚體水平、腦栓塞發(fā)生率、出血發(fā)生率。結(jié)果：研究組和對(duì)照組治療后血漿中D-二聚體水平分別為（3.0±0.5）mg/L和（2.9±0.7）mg/L，比較差異無(wú)統(tǒng)計(jì)學(xué)意義（t=0.965，P=0.168）。研究組和對(duì)照組患者腦栓塞發(fā)生率分別為11.43%和7.46%，比較差異無(wú)統(tǒng)計(jì)學(xué)意義（字2=0.628，P=0.428）。研究組出血率為1.43%，顯著低于對(duì)照組的8.96%，差異有統(tǒng)計(jì)學(xué)意義（字2=3.982，P=0.046）。結(jié)論：吲哚布芬用于預(yù)防房顫患者腦栓塞的效果與華法林相似，但擁有更低的出血發(fā)生率，對(duì)房顫患者而言，吲哚布芬是一種可行的替代方案。

【關(guān)鍵詞】 吲哚布芬; 華法林; 房顫; 抗凝

doi：10.14033/j.cnki.cfmr.2019.07.087 文獻(xiàn)標(biāo)識(shí)碼 B 文章編號(hào) 1674-6805（2019）07-0-03

Efficacy and Nursing Experience of Indobufen Versus Warfarin for Anticoagulant Therapy in Patients with Atrial Fibrillation/LIU Yueying.//Chinese and Foreign Medical Research，2019，17（7）：-182

【Abstract】 Objective：To investigate the efficacy and nursing experience of Indobufen versus Warfarin for anticoagulant therapy in patients with atrial fibrillation.Method：A total of 137 patients with atrial fibrillation admitted to the Second Affiliated Hospital of Fujian Medical University from February 2016 to July 2017 were randomly divided into study group（70 cases） and control group（67 cases）.Both groups were given routine nursing.The control group was given oral Warfarin 5 mg，and the study group was given oral Indobufen Tablets.The plasma levels of D-dimer，the incidence of cerebral embolism and the hemorrhage were compared between the two groups.Result：The level of D-dimer in plasma in the study group and the control group were （3.0±0.5）mg/L and （2.9±0.7）mg/L，

respectively，and the difference was not significant（t=0.965，P=0.168）.The incidences of cerebral thrombosis were 11.43% and 7.46% in the study group and the control group respectively，and the difference was not significant（字2=0.628，P=0.428）.The hemorrhage rate in the study group was 1.43%，which was significantly lower than 8.96% in the control group （字2=3.982，P=0.046）.Conclusion：Indobufen was similar to warfarin in preventing cerebral embolism in patients with atrial fibrillation，but it has a lower incidence of bleeding.For patients with atrial fibrillation，Indobufen is a viable alternative.

【Key words】 Indobufen; Warfarin; Atrial fibrillation; Anticoagulation

First-authors address：The Second Affiliated Hospital of Fujian Medical University，Quanzhou 362000，China

心源性腦栓塞是非瓣膜性房顫最重要的并發(fā)癥，也是影響患者生存治療最重要的因素。在未接受抗凝治療的非瓣膜性房顫，心源性腦栓塞的發(fā)生率可高達(dá)25%，抗凝治療對(duì)預(yù)防心源性腦栓塞具有非常重要的意義?？诜A法林是預(yù)防房顫相關(guān)腦栓塞的標(biāo)準(zhǔn)治療方法，可以使房顫患者發(fā)生心源性腦栓塞的風(fēng)險(xiǎn)降低54%～61%。然而，藥物相關(guān)性出血，包括皮膚紫癜、內(nèi)臟出血、腦出血等是華法林重要藥物風(fēng)險(xiǎn)，因此臨床上需要監(jiān)測(cè)用藥者的凝血功能和凝血酶原時(shí)間國(guó)際標(biāo)準(zhǔn)化比值（INR）。吲哚布芬是一類新型的抗血小板藥物，具有藥物不良反應(yīng)小等特點(diǎn)[1-3]。多項(xiàng)研究表明，吲哚布芬對(duì)房顫患者或非房顫患者血栓栓塞具有良好的二級(jí)預(yù)防作用[4-5]。2016年2月-2017年7月筆者所在科室70例患者使用吲哚布芬預(yù)防房顫的心源性腦栓塞，取得了良好的效果，現(xiàn)報(bào)道如下。