儿童口服抗凝治疗调查
Survey of oral anticoagulant treatment in children.
作者信息
Evans D I, Rowlands M, Poller L
机构信息
Royal Manchester Children's Hospital.
出版信息
J Clin Pathol. 1992 Aug;45(8):707-8. doi: 10.1136/jcp.45.8.707.
AIMS
To find out which children are treated with oral anticoagulants and how their treatment is controlled in the United Kingdom.
METHODS
Two questionnaires were used. The first was sent to general haematologists and the other to paediatric cardiologists and cardiac surgeons.
RESULTS
There were 273 (58%) replies to the first questionnaire. Most children were treated because of artificial cardiac valve replacement. The mean target International Normalised Ratio (INR) used was 2.73 to 4.0 for children with heart valves and 2.1 to 3.25 for children with venous thrombosis. The second questionnaire elicited replies from 11 of 22 cardiac centres. The mean target INR used for children with cardiac valves ranged from 2.59-3.77. Of 68 children covered in the survey, there have been two major bleeds and two thrombotic episodes: 78.8% of children were controlled with a venous prothrombin time and 21.2% with a capillary test. There was no consistency in the dose regimens used for the induction of oral anticoagulant treatment with warfarin.
CONCLUSIONS
The levels of anticoagulation used for maintenance are similar to those recommended by the British Society for Haematology for adults (3.0 to 4.5). They seem to be safe for children too.
目的
查明在英国哪些儿童接受口服抗凝剂治疗以及他们的治疗是如何控制的。
方法
使用了两份调查问卷。第一份问卷发送给普通血液科医生，另一份发送给儿科心脏病专家和心脏外科医生。
结果
第一份问卷收到了273份（58%）回复。大多数儿童因人工心脏瓣膜置换而接受治疗。心脏瓣膜病儿童使用的平均目标国际标准化比值（INR）为2.73至4.0，静脉血栓形成儿童为2.1至3.25。第二份问卷从22个心脏中心中的11个得到了回复。心脏瓣膜病儿童使用的平均目标INR范围为2.59 - 3.77。在调查涵盖的68名儿童中，发生了两例大出血和两例血栓形成事件：78.8%的儿童通过静脉凝血酶原时间进行控制，21.2%通过毛细血管试验进行控制。在使用华法林进行口服抗凝治疗诱导时，所用的剂量方案不一致。
结论
维持抗凝的水平与英国血液学会为成年人推荐的水平（3.0至4.5）相似。它们对儿童似乎也很安全。
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