Hambleton Julie
Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, CA, 94143-1270, USA.
J Thromb Thrombolysis. 2003 Aug-Oct;16(1-2):39-42. doi: 10.1023/B:THRO.0000014591.32012.1f.
Small portable devices that generate a prothrombin time/INR from fingerstick capillary blood simplify warfarin management by allowing selected patients to monitor and manage their own warfarin dose. Early studies established that patients can self-test at home, with results as accurate as those obtained by practitioners. Point-of-care testing of elderly patients resulted in tighter INR control and a lower incidence of major hemorrhage, especially at the initiation of anticoagulant therapy. Patients can also successfully self-manage warfarin therapy. Larger, prospective, randomized intervention studies have shown that patient self-management led to greater time spent within the therapeutic INR range. However, a shift toward patient self-testing will likely require centralized implementation of patient education, training, and follow up that will need to be established in the clinic setting or by a third party.
通过指尖毛细血管血生成凝血酶原时间/国际标准化比值（INR）的小型便携式设备，使特定患者能够自行监测和管理华法林剂量，从而简化了华法林的管理。早期研究证实，患者能够在家中进行自我检测，检测结果与医生所测结果一样准确。对老年患者进行即时检验可使INR控制更加严格，大出血发生率降低，尤其是在抗凝治疗开始时。患者也能够成功地自我管理华法林治疗。规模更大的前瞻性随机干预研究表明，患者自我管理可使在治疗性INR范围内的时间更长。然而，要转向患者自我检测，可能需要在临床环境中或由第三方集中开展患者教育、培训及随访工作。
