Journal of Clinical Pediatrics ›› 2020, Vol. 38 ›› Issue (10): 736-.doi: 10.3969/j.issn.1000-3606.2020.10.004

Previous Articles     Next Articles

Effect of heparin combined with warfarin in the treatment of thrombogenesis in children

DU Qingxia, LI Lei, BIE Wenhui, LI Xinxiang, YU Peiru, ZHOU Xin, ZHANG Xin   

  1. Cardiovascular Medicine Department, Qilu Pediatric Hospital of Shandong University, Jinan 250022, Shandong, China
  • Online:2020-10-15 Published:2020-10-10

Abstract: Objective? To?explore?the?common?causes?of?thrombogenesis?in?children?and?observe?the?anticoagulant? effect?of?heparin?combined?with?warfarin.?Methods? The?clinical?data?of?children?diagnosed?with?thrombosis?and?receiving? anticoagulant?treatment?of?heparin?combined?with?warfarin?from?March?2017?to?March?2019?were?analyzed?retrospectively.? According?to?the?target?value?of?international?standardized?ratio?(INR)?during?treatment,?the?children?were?divided?into?INR? 1.0~1.5?group,?INR?1.5~2.0?group?and?INR>2.0?group,?and?the?duration?and?efficacy?of?anticoagulation?therapy?among?the?three? groups?were?compared?and?analyzed.?Results? Sixty-four?children?were?included?(40?males?and?24?females),?and?29?patients? (45.3%)?were?younger?than?2?years?old.?The?primary?diseases?were?mainly?hematological?tumor?diseases?(36?cases,?56.2%)?and? cardiovascular?diseases?(20?cases,?31.2%).?Thrombogenesis?was?caused?by?central?venous?catheterization?in?38?cases?(59.38%),? peripheral?arteriovenous?puncture?in?12?cases?(18.75%),?severe?infection?in?4?cases?(6.25%),?tumor?in?4?cases?(6.25%),?femoral? venous?catheterization?in?2?cases?(3.12%),?arrhythmia?in?2?cases?(3.12%),?and?coronary?artery?disease?of?Kawasaki?disease?in?2? cases?(3.12%).?There?were?20?cases?in?the?INR?1.0~1.5?group?(11?males?and?9?females),?28?cases?in?the?INR?1.5~2.0?group?(18? males?and?10?females),?and?13?cases?in?the?INR>2.0?group?(9?males?and?4?females).?There?was?a?statistically?significant?difference? in?the?median?time?of?anticoagulation?treatment?among?the?three?groups?(P<0.05).?In?pairwise?comparison,?the?anticoagulation? treatment?time?in?the?INR?1.5~2.0?group?was?significantly?shorter?than?that?in?the?INR?1.0~1.5?group,?and?the?difference?was? statistically?significant?(P=0.014).?Conclusion? Anticoagulation?is?the?main?method?for?the?treatment?of?thrombogenesis?in? children?and?its?efficacy?is?good.?Low-dose?warfarin?anticoagulation?can?inhibit?thrombogenesis?and?there?is?no?need?to?adjust? INR?to?>2.0.

Key words: thrombogenesis;? anticoagulant?therapy;? heparin;? warfarin;? child