目的探讨房颤患者应用华法林抗凝治疗的疗效。方法用药前测INR 1次,每天服用1次华法林,初始剂量2.5~3.0 mg/d,应用华法林3 d后复查INR,以后每天监测,根据INR调整剂量,每次0.5 mg为调整单位。若INR连续2 d稳定在2.0~3.0之间,每周检测2~3次,以后每周检测1次,1个月后改为每月检测1次,6个月后改为每2个月检测1次。若有出血等不良反应和栓塞并发症发生时即查血浆凝血酶原时间(PT)、INR。结果52例患者均得到随访,随访时间6个月~4年,华法林维持量为(3.0±0.05)mg/d。随访期间血栓栓塞并发症及不良反应脑栓塞2例,其中1例为既往发生过脑卒中的高血压患者;1例为瓣膜病患者;脑出血2例,为人工瓣膜患者,因咳嗽、咯痰、发热,在院外静点头孢曲松钠3.0 g(1次/d),1周后复查INR为8.45;黑便1例、血尿1例、球结膜出血2例、皮下出血2例、牙龈出血2例,经调整华法林剂量及对症处理后出血症状消失。结论心房颤动一旦确诊,又无抗凝禁忌,应常规给予华法林抗凝治疗,以尽早达到治疗效果。 Objective To investigate the effect of anticoagulation with warfarin in patients with atrial fibrillation. Methods The patients were given INR once before taking the medicine and taking warfarin once daily. The initial dose was 2.5-3.0 mg / d. The patients were re-examined after 3 days of warfarin treatment and then monitored daily. The dosage of 0.5 mg was adjusted according to INR unit. If the INR for two consecutive days in the stability of 2.0 to 3.0, 2 to 3 times a week test, the following test once a week, 1 month to 1 test every month, 6 months later changed to every 2 months Test once. If bleeding and other adverse reactions and embolic complications that check when the plasma prothrombin time (PT), INR. Results All 52 patients were followed up for 6 months to 4 years. Warfarin maintenance was (3.0 ± 0.05) mg / d. 2 cases of thromboembolic complications and adverse reactions during follow-up, 1 case of hypertensive patients with previous stroke; 1 case of valvular disease; 2 cases of intracerebral hemorrhage as prosthetic valve due to cough and expectoration , Fever, intravenous ceftriaxone sodium 3.0 g (1 / d), 1 week after the review INR was 8.45; black stool in 1 case, hematuria in 1 case, conjunctival hemorrhage in 2 cases, 2 cases of subcutaneous bleeding, bleeding gums 2 cases, the adjusted warfarin dose and symptomatic treatment of bleeding disappeared. Conclusions Once the diagnosis of atrial fibrillation, and no contraindications to anticoagulation, warfarin anticoagulation should be routinely given to achieve early treatment.