MARPLE C D
Calif Med. 1950 Aug;73(2):166-70.
Heparin is administered parenterally. Its therapeutic effect is measured by the clotting time of the whole blood, determined by the method of Lee and White. An excessive anticoagulant effect is controlled by the administration of specific antagonists, toluidine blue or protamine sulfate. Dicumarol* is admintered orally in amounts sufficient to reduce the prothrombin activity of the plasma to between 10 and 30 per cent of normal. The prothrombin time, which represents such a reduction in prothrombin activity, will vary according to the method by which the determination is performed, the thromboplastin used, and the technique followed. Excessive prolongation of the prothrombin time is antagonized by the administration of vitamin K in large doses. Long-term therapy with Dicumarol is sufficiently hazardous to require considerable experience on the part of the physician. Where an immediate anticoagulant effect is necessary, yet prolonged administration anticipated, combined therapy with both heparin and Dicumarol may be used until the prothrombin time is prolonged satisfactorily, whereupon heparin may be discontinued.
肝素通过胃肠外途径给药。其治疗效果通过全血凝固时间来衡量，采用李-怀特法测定。过量的抗凝作用可通过给予特定拮抗剂甲苯胺蓝或硫酸鱼精蛋白来控制。双香豆素*口服给药，剂量足以将血浆中凝血酶原活性降至正常水平的10%至30%。代表凝血酶原活性降低的凝血酶原时间会因测定方法、所用组织凝血活酶以及操作技术的不同而有所变化。凝血酶原时间过度延长可通过大剂量给予维生素K来对抗。双香豆素的长期治疗具有足够的危险性，需要医生具备相当的经验。在需要立即产生抗凝作用但预计要长期给药的情况下，可同时使用肝素和双香豆素进行联合治疗，直到凝血酶原时间得到满意延长，届时可停用肝素。
