• Title/Summary/Keyword: 항응고제

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The Use of Nafamostat Mesilate as an Anticoagulant during Continuous Renal Replacement Therapy for Children with a High Risk of Bleeding (출혈성 경향이 높은 소아환자의 지속성 신대체 요법시 사용되는 항응고제로서 Nafamostat mesilate의 사용)

  • Lee, Sang Taek;Cho, Heeyeon
    • Childhood Kidney Diseases
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    • v.18 no.2
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    • pp.98-105
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    • 2014
  • Purpose: Nafamostat mesilate (NM), a synthetic serine protease inhibitor, has been investigated as an anticoagulant for adult patients with a high risk of bleeding, who need chronic renal replacement therapy (CRRT). However, little is known about the use of NM as an anticoagulant in pediatric CRRT. The aim of this study was to evaluate the ideal dosage, efficacy, and safety of NM in pediatric CRRT. Methods: We conducted a retrospective study of 40 pediatric patients who had undergone at least 24 h of venovenous CRRTs between January 2011 and October 2013. We divided the patients according to risk of bleeding. Those at high risk received no anticoagulation (group 1) or NM as an anticoagulant (group 2), while those at low risk received heparin (group 3). Results: Forty patients (25 male and 15 female; mean age, $8.2{\pm}6.6$ years) were enrolled. The mean duration of CRRT was 13.0 days, and the survival rate was 57.5%. The mean hemofilter lifespan was 39.3 h in group 1 and 11.3 h in group 3. In group 2, hemofilter lifespan was extended from 7.5 h to 27.4 h after the use of NM (P =0.001). The mean hemofilter lifespan with NM was greater than with heparin (P =0.018). No patient experienced a major bleeding event during treatment with NM. Conclusion: NM may be a good alternative anticoagulant in pediatric patients with a high risk of bleeding requiring CRRT, and is not associated with bleeding complications.

The level of Knowledge Related to Disease in Patients with Atrial fibrillation (심방세동 환자의 질병관련 지식 정도)

  • Kim, Kyunghee;Song, Juhyun;Shin, Seung Yong
    • Journal of the Korea Convergence Society
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    • v.12 no.6
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    • pp.249-258
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    • 2021
  • The aim of this study was to determine the level of knowledge related to disease in patients with atrial fibrillation. We used the Jessa Atrial fibrillation Knowledge Questionnaire (JAKQ) and Knowledge of Atrial Fibrillation and Stroke Prevention Questionnaire(KAFSP). A total of 222 AF patients completed the JAKQ and KAFSP. The mean score of the JAKQ and KAFSP 54.7 and 18.5 points, respectively. In general, patients with Atrial fibrillation were well aware that atrial fibrillation causes stroke and that anticoagulants should be taken to prevent blood clots. However, they were not well aware of the precautions for taking anticoagulants, symptoms of atrial fibrillation, and treatment of atrial fibrillation. There was no statistically significant difference in atrial fibrillation knowledge score according to anticoagulants but the degree of knowledge related to VKA was low in patients taking VKA. The both score of JAKQ and KAFSP had significant differences in atrial fibrillation knowledge depending on the level of education. Based on these finding, it is necessary to develop a customized education program in order to improve the knowledge of patients with atrial fibrillation.

Thrombolytic Therapy for Repeated Prosthetic Valvular Thrombosis That's Associated with Pregnancy under Heparin Anticoagulation (임신과 연관된 헤파린 항응고요법 중 반복적으로 발생한 인공판막 혈전증의 혈전용해치료)

  • Choe, Ju-Won;Kim, Yong-In L.
    • Journal of Chest Surgery
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    • v.41 no.4
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    • pp.484-488
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    • 2008
  • During long-term anticoagulation treatment with using heparin in a pregnant patient with a mechanical mitral prosthesis, we observed several anticoagulation-related complications, including repeated prosthetic valve thrombosis. This was found to be caused by heparin resistance due to an anti-thrombin III deficiency. Thrombolytic therapy using urokinase or tissue plasminogen activator (tPA) was successful and safe for her as well as her baby.

Mitral Valve Replacement with a Pulmonic Autograft (자가 폐동맥 판막을 이용한 승모판막 치환술- 1례 보고 -)

  • 이재원;김건일;정성호;최현정;송명근
    • Journal of Chest Surgery
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    • v.34 no.4
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    • pp.361-364
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    • 2001
  • 자가 폐동맥 판막을 이용한 대동맥 판막 치환술을 항응고제 복용이 필요없고 내구성이 어느정도 입증되어 늘어나고 있으나, 자가 폐동맥 판막을 이용한 승모판막 치환술은 국내에 보고된 예가 없다. 53세 여자 환자로 류마티스성 승모판막 협차가 및 폐쇄부전, 삼첨판막 폐쇄부전, 만성 심방 세동, 그리고 자회전 관상동맥의 폐색등으로 진단받은 환자에서 자가 폐동맥 판막을 이용한 승모판막 치환술 및 maze 술식, 삼천판막 성형술, 관상동맥 우회수술을 시해하였다. 수술후 특별한 문제없이 회복하였으며 술후 시행한 심초음파 검사상 자가 폐동맥 판막의 이상 소견없이 잘 기능하고 있으며 항응고제 복용없이 잘 지내고 있다.

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Acute Compartment Syndrome after Anticoagulant Therapy to Misdiagnosed Deep Vein Thrombosis (오인된 심부 정맥 혈전증에 대하여 항응고제 투여 후 발생한 급성 구획 증후군)

  • Hwang, Seok-Ha;Jeon, Ho-Seung;Woo, Young-Kyun;Lim, Seong-Tae
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.2
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    • pp.177-181
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    • 2019
  • Acute compartment syndrome, which is an orthopedic emergency, induces irreversible tissue necrosis by increasing the compartment pressure. In serious cases, this event may result in functional impairment, loss of the lower limb, and death by renal failure. When the patient initially presents with pain and swelling that are similar to deep vein thrombosis, a differential diagnosis between the two diseases is very critical. The authors encountered a case of acute compartment syndrome after anticoagulant therapy in a patient presenting with painful swelling of the left leg following a massage that was initially misdiagnosed as deep vein thrombosis. A fasciotomy was performed on this case with satisfactory results. This paper reports this case with a review of the relevant literature.

설페이티드 다당류의 실험실적 효능 검색과 동물내에서의 비교

  • 김영식
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1993.04a
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    • pp.76-76
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    • 1993
  • 헤파린은 혈액응고계에서 antithrombin III 존재하에서 thrombin과 factor Xa의 작용을 억제함으로써 항응고제로서 작용을 한다. 심정맥혈전증 등 임상에 응용성이 높지만 장기적 사용시 혈소판 감소효과, 출혈, 골다공증 등의 부작용이 나타나고 있다. 본연구는 식물성 생약으로부터 당을 분리 정제하여 화학적으로 sulfation시켜 in vitro와 ex vivo에서 항응고활성을 비교하였다. 우선적으로 aPTT를 측정하여 응고시간의 연장을 시키는 다섯종류의 식물생약을 선택하였고 이 중에서 청호(Artemisiae apiaceae)로부터 산성당을 분리하여 pyridine과 chlorosulfonic산으로 sulfation 시켰율 때 in vitro상에서 항응고활성은 sulfation전에 비해 두드러지게 증가하였다. 농도를 달리 하여 실험동물에 투여시 응고시간의 연장 역시 비슷한 양상을 보여주었다. Thrombin 억제는 발견되지 않았지만 sulfate기와 항응고 활성과는 관계가 있는 것처럼 보였다.

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Warfarin-induced Skin Necrosis After Valve Surgery (판막수술 후 항응고제 투여로 인한 피부괴사증)

  • Moon, Seung-Chul;Lee, Gun;Lee, Hyeon-Jae;Ahn, Dae-Ho;Lim, Chang-Young
    • Journal of Chest Surgery
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    • v.32 no.3
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    • pp.307-309
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    • 1999
  • Warfarin-induced skin necrosis is a rare complication caused by transient hypercoagulable state. This state is a result of rapid decline of the protein C activity relative to that of coagulation factor II, IX, and X during initiation of oral anticoagulant therapy. We experienced a case of warfarin-induced skin necrosis involving both breasts in a patient who underwent double valve replacement 1 month before. Warfarin was replaced to a low- molecular weight heparin and the necrotic breast lesion was healed spontaneously. Low-dose warfarin was restarted and gradually increased, after which a low molecular weight heparin discontinued..

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Open Heart Surgery in a Pregnant Woman with Prosthetic Valve Failure (기계판막 기능부전이 동반된 임산부에서의 개심수술)

  • 이현주;김기봉
    • Journal of Chest Surgery
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    • v.34 no.3
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    • pp.240-242
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    • 2001
  • 임심 중 심폐바이패스를 사용하는 개심수술은 산모뿐 아니라 태아계에도 영향을 끼치기 때문에 중요하다. 임신 중 항응고제 투여을 부적절하게 하여 기계판막 기능부전이 초래된 임신 31주의 산모에서 심장 재수술에 앞서 제왈절개로 태아 출산 후 20시간 뒤 산모의 개시수술을 성공적으로 시행하였기에 보고하는 바이다.

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Prevention and Dissociation of the Platelet Aggregation in a Patient with EDTA-dependent Pseudothrombocytopenia by Supplementation of Kanamycin : A Case Report (EDTA 의존성 가성혈소판감소증 환아에서 가나마이신 보충에 의해 혈소판 응집을 예방할 수 있었던 1례)

  • Jeon, In-Sang;Yang, Sung Wan
    • Clinical and Experimental Pediatrics
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    • v.48 no.6
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    • pp.675-677
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    • 2005
  • Pseudothrombocytopenia is usually associated with anticoagulant ethylene diaminetetraacetic acid (EDTA). The platelet clumping that occurs in EDTA-dependent pseudothrombocytopenia (EDPT) can sometimes be prevented by the use of other anticoagulants such as heparin or sodium citrate. As an alternative, we used kanamycin before or after the withdrawal of EDTA-anticoagulated blood in a 6-year-old boy with EDPT. Kanamycin used supplementarily during the differentiation of EDPT effectively prevented platelet clumping.