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1例42岁女性患者三尖瓣置换术后为预防血栓服用华法林(3.00 mg/d).用药第3天查凝血酶原时间(PT)15.5 s,国际标准化比值(INR) 1.3,将华法林调整为3.75 mg/d.第8天患者出现心房颤动,心率81次/min,遂加用胺碘酮0.2g,1次/d口服.第16天患者出现肉眼血尿.实验室检查:PT 60.0 s,INR 5.1,尿红细胞计数300/μl.停用华法林,胺碘酮维持原剂量,肌内注射维生素K110 mg.4h后PT 48.2 s,INR 4.1,再次肌内注射维生素K1 10 mg.4h后PT 18.7 s,INR 1.6,尿液颜色逐渐恢复正常.第17天复查,PT 16.6 s,INR 1.4,尿红细胞计数阴性,恢复华法林抗凝治疗(1.50 mg/d).“,”A 42-year-old female received warfarin 3.00 mg/d to prevent thromboembolism after replacement of tricuspid valve.On day 3 of treatment,her prothrombin time (PT) was 15.5 s and the international noimalized ratio (INR) was 1.3,warfarin was adjusted to 3.75 mg/d.On day 8,the patient presented atrial fibrillation,the heart rate was 81 beats/min,then amiodarone 0.2 g oral administration once daily was added.On day 16,the patient presented hematuria,laboratory tests showed the following values:PT 60.0 s,INR 5.1,urine red blood cell count 300/μl,warfarin was withdrawn immediately and amiodarone was maintained at the original dose.At the same time,the patient received an IM injection of vitamin K1 10 mg.Four hours later,her PT and INR decreased to 48.2 s and 4.1,respectively.The patient was received an IM injection of vitamin K1 10 mg again.Four hours later,her PT and INR decreased to 18.7 s and 1.6,respectively.The urine color gradually returned to normal.On day 17,PT and INR were 18.7 s and 1.6,respectively,urine red blood cell count was zero.The anticoagulant therapy with warfarin 1.50 mg/d was resumed.