目的 了解儿童血栓形成的常见病因，观察肝素联合华法林抗凝治疗效果。方法 回顾分析2017年3月至 2019年3月诊断为血栓形成并接受肝素联合华法林抗凝治疗患儿的临床资料。根据治疗过程中国际标准化比值的（INR）目 标值将患儿分为INR?1.0~1.5组、INR?1.5~2.0组及INR>2.0组，比较分析三组患儿抗凝治疗时间及疗效。结果 纳入64 例患儿，男40例、女24例， <2岁29例（45.3%）。 原发病以血液肿瘤疾病（36例，56.2%）、心血管疾病（20例，31.2%）为主。 血栓形成原因为中心静脉置管38例（59.38%）、外周动静脉穿刺12例（18.75%）、重症感染4例（6.25%）、肿瘤4例（6.25%）、 股静脉置管2例（3.12%）、心律失常2例（3.12%）、川崎病冠状动脉病变2例（3.12%）。INR?1.0~1.5组20例（男11例、女9例）， INR?1.5~2.0组28例（男18例、女10例），INR>2.0组13例（男9例、女4例），三组间抗凝治疗中位时间差异有统计学意义 （P<0.05）。 两两比较，INR?1.5~2.0组较INR?1.0~1.5组抗凝所用时间明显缩短，差异有统计学意义（P=0.014）。 结论 抗 凝是治疗儿童血栓形成的主要方法且效果良好，低剂量华法林抗凝即可抑制血栓形成，无需将INR调整到>2.0。

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.