Feasibility of anticoagulation therapy after mechanical valve replacement in grass-root health institutions
10.3760/cma.j.issn.1671-7368.2015.08.009
- VernacularTitle:基层医院与三级医院心脏机械瓣膜置换术后华法林抗凝治疗效果的比较
- Author:
Longhui GUO
;
Jingchao ZHANG
;
Chao LIU
;
Wenyi WANG
;
Liwen WU
;
Xiaodong SONG
- Publication Type:Journal Article
- Keywords:
Heart valve prothesis implantation;
Warfarin;
Anticoagulation therapy;
Hospitals,general;
Hospitals,community
- From:
Chinese Journal of General Practitioners
2015;14(8):607-610
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the feasibility of anticoagulation therapy after mechanical valve replacement in grass-root health institutions.Methods One hundred and sixty one patients with mechanical valve replacement received anticoagulation therapy with warfarin,including 79 cases receiving the therapy in grass-root health institutions (test group) and 82 cases in the tertiary hospitals (control group).The patients were followed up for 12 months after operation;the rate of anticoagulation efficacy,the anticoagulationrelated complications,and the anticoagulation-related cost were documented and compared between two groups.Results The international normalized ratio (INR) tests were performed for 1 021 times in test group and 717 times were up to anticoagulation standard (70.2 ％,717/1 021),while INR tests in control group were performed for 965 times and 688 times were up to standard (71.3％,688/965);there were no significantly differences in efficacy rate between two groups (P ＞ 0.05).There were no significant differences in rate of bleeding events and thrombosis between two groups [16.5％ (13/79) vs.12.2％ (10/82),6.3％(5/79) vs.4.9％(4/82),respectively,x2 =0.596,P=0.44,x2 =0.161,P=0.69].The anticoagulation-related cost per month and per patient in test group was significantly lower than those in control group [(63.1 ±.12.8) vs.(176.6 ± 16.4) yuan,t =48.716,P ＜0.05].Conclusion Compared with the tertiary hospital,the anticoagulation therapy in grass-root institutions can accomplish the similar clinical outcomes and significantly reduce the medical cost in patients with mechanical valve replacement.
