慢性血栓栓塞性肺动脉高压患者华法林治疗失败：病例报告及文献综述
Warfarin Failure in a Patient With Chronic Thromboembolic Pulmonary Hypertension: A Case Report and Literature Review.
作者信息
Dolkar Tsering, Chaudry Aysham, Salauddin Ferdous, Nway Nway, Kadakia Nevil, Kalavar Madhumati, Dogar Muhammad H
机构信息
Internal Medicine, One Brooklyn Health (OBH) Interfaith Medical Center, Brooklyn, USA.
Medicine, Touro College of Osteopathic Medicine, Middletown, USA.
出版信息
Cureus. 2022 Jul 19;14(7):e27007. doi: 10.7759/cureus.27007. eCollection 2022 Jul.
Chronic thromboembolic pulmonary hypertension (CTEPH) is a form of pulmonary hypertension caused by chronic venous thromboembolism (VTE). Venous thromboembolism (VTE) manifests as deep vein thrombosis (DVT), progressing to pulmonary embolism (PE). Pulmonary endarterectomy (PEA) is the preferred therapeutic option as it provides vascular disobliteration. Long-term anticoagulation with warfarin or direct oral anticoagulants (DOACs) is recommended for patients at risk for recurrent DVT in poor surgical candidates. However, treatment failure remains a concern. We present a patient who had VTE despite long-term anticoagulation with warfarin who had failed treatment and developed VTE with a therapeutic dilemma to continue anticoagulation despite supratherapeutic international normalized ratio (INR).
慢性血栓栓塞性肺动脉高压（CTEPH）是一种由慢性静脉血栓栓塞症（VTE）引起的肺动脉高压形式。静脉血栓栓塞症（VTE）表现为深静脉血栓形成（DVT），进而发展为肺栓塞（PE）。肺动脉内膜剥脱术（PEA）是首选的治疗方法，因为它能实现血管再通。对于手术条件较差且有复发性DVT风险的患者，建议长期使用华法林或直接口服抗凝剂（DOACs）进行抗凝治疗。然而，治疗失败仍是一个问题。我们报告了一名患者，尽管长期使用华法林抗凝治疗，但仍发生了VTE，治疗失败，并且在国际标准化比值（INR）高于治疗范围的情况下出现了VTE，面临着是否继续抗凝的治疗困境。
Zotero 插件