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Initial Evaluation of Raschke Nomogram

作者:Hua Luo   发布时间:2012-09-18 08:17:50   浏览次数:594
Initial Evaluation of Raschke Nomogram asHeparin Anticoagulation Guidance in Chinese Patients with Pulmonary Thromboembolism
LUO Hua ICU of Peking University Shenzhen HospitalShenzhen 518036ChinaLIANG YingDepartment of Pulmonary Medicine, Beijing Anzhen Hospital, affiliated hospital of Capital University of Medical Science, Beijing 100029,China
 
Abstract  Objective  To evaluate confronted problems of Raschke nomogram as anticoagulation guidance in Chinese patients with pulmonary thromboembolism. Methods 25 PTE cases were guided by Raschke nomogram, the numbers of APTT and heparin dosages every 6 h with 84 hours after beginning anticoagulation were recorded sequently. The APTT tendency curve was delineated. The rate to achieve APTT target in different period, time to achieve APTT target steadily, APTT adjustment frequency and APTT variation caused by each unit of heparin dosage were calculated respectively. Effected factors on therapy of Raschke nomogram were summarized. Results The rate to achieve APTT target steadily on first 24 hours and 72 hours were 27.78% and 83.32% separately. The rate beyond APTT target on first 24 hours was 61.11%.It had need 36 hours and 12 times of APTT detection in average to achieve APTT target and lead to the fluctuation rate of APTT higher than 74%. APTT variation was 42 seconds caused by each unit of heparin dosage. Conclusion By using Raschke nomogram to treat Chinese patients, there were difference in heparin dosage selection, accuracy and adjustment degree with foreigner . Some co-existing factors such as heparin loading dosage, warfarin, endogenous APTT and complication could affect reaching APTT target .
    [Key words]  Heparin; APTT;Pulmonary Thromboembolism;Anticoagulation therapy;Raschke nomogram






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