1).ʻO nā maʻi maʻi maʻi

ʻO ka maʻi cardioembolic kahi maʻi ischemic i hoʻokumu ʻia e ka hoʻokahe ʻana o ka emboli cardiogenic a me ka hoʻoulu ʻana i nā aʻa cerebral e pili ana, e helu ana no 14% a 30% o nā maʻi ischemic āpau.Ma waena o lākou, ʻoi aku ka nui o ka hahau pili i ka atrial fibrillation ma mua o 79% o nā maʻi cardioembolic āpau, a ʻoi aku ka koʻikoʻi o ka maʻi cardioembolic, a pono e ʻike ʻia i ka wā mua a me ka hana ikaika.No ka loiloi i ka pilikia thrombosis a me ka mālama ʻana i ka anticoagulation o nā mea maʻi, a me ka mālama anticoagulation ke kino pono e hoʻohana i nā hōʻailona coagulation e loiloi i ka hopena anticoagulation a me ka lāʻau anticoagulation kūpono e pale i ke koko.

ʻO ka pilikia nui loa i nā maʻi me ka atrial fibrillation he arterial thrombosis, ʻoi aku ka cerebral embolism.Nā ʻōlelo aʻoaʻo anticoagulation no ka cerebral infarction lua i ka atrial fibrillation:
1. ʻAʻole ʻōlelo ʻia ka hoʻohana maʻamau o nā anticoagulants no nā poʻe maʻi me ka maʻi cerebral infarction.
2. I nā poʻe maʻi i mālama ʻia me ka thrombolysis, ʻaʻole pono e hoʻohana i nā anticoagulants i loko o 24 mau hola.
3. Inā ʻaʻohe contraindications e like me ke kahe koko, ke akepaʻa koʻikoʻi a me ka maʻi kīkī, ke kahe koko> 180/100mmHg, a me nā mea ʻē aʻe, hiki ke noʻonoʻo ʻia nā kūlana ma lalo nei i ka hoʻohana ʻana i nā anticoagulants.
(1) ʻO nā poʻe maʻi me ka maʻi puʻuwai (e like me ka valve artificial, atrial fibrillation, myocardial infarction me ka thrombus mural, left atrial thrombosis, a me nā mea ʻē aʻe) hiki ke loaʻa i ka hahau hou.
(2) ʻO nā maʻi me ka maʻi ischemic i hele pū me ka protein C deficiency, protein S deficiency, active protein C resistance a me nā mea maʻi thromboprone;nā maʻi me ka hōʻailona extracranial dissecting aneurysm;nā maʻi me ka stenosis intracranial a intracranial artery.
(3) Hiki i nā poʻe maʻi moe me ka maʻi cerebral infarction ke hoʻohana i ka heparin haʻahaʻa a i ʻole ka nui o ka LMWH e pale ai i ka thrombosis vein hohonu a me ka embolism pulmonary.

2).ʻO ka waiwai o ka nānā ʻana i ka coagulation index i ka wā e hoʻohana ʻia ai nā lāʻau anticoagulant

• PT: Maikaʻi ka hana INR o ke keʻena hana a hiki ke hoʻohana ʻia e alakaʻi i ka hoʻoponopono ʻana o ka warfarin;e nānā i ka pilikia o ke koko o rivaroxaban a me edoxaban.
• APTT: Hiki ke ho'ohana 'ia no ka loiloi 'ana i ka pono a me ka palekana o ka heparin unfractionated a me ka no'ono'o pono i ka pilikia o ke koko o ka dabigatran.
• TT: Paʻa i ka dabigatran, hoʻohana ʻia e hōʻoia i ke koena dabigatran i loko o ke koko.
• D-Dimer/FDP: Hiki ke hoʻohana ʻia e loiloi i ka hopena therapeutic o nā lāʻau anticoagulant e like me warfarin a me heparin;a e loiloi i ka hopena therapeutic o nā lāʻau thrombolytic e like me urokinase, streptokinase, a me alteplase.
• AT-III: Hiki ke hoʻohana ʻia e alakaʻi i nā hopena lāʻau o ka heparin, ka haʻahaʻa molecular weight heparin, a me ka fondaparinux, a e hōʻike i ka pono e hoʻololi i nā anticoagulants i ka hana lapaʻau.

3).Anticoagulation ma mua a ma hope o ka cardioversion o atrial fibrillation

Aia ka pilikia o ka thromboembolism i ka wā cardioversion o ka fibrillation atrial, a hiki i ka lāʻau anticoagulation kūpono ke hōʻemi i ka pilikia o ka thromboembolism.No nā poʻe maʻi hemodynamically unstable me ka atrial fibrillation e koi ana i ka cardioversion wikiwiki, ʻaʻole pono ka hoʻomaka ʻana o ka anticoagulation e hoʻopaneʻe i ka cardioversion.Inā ʻaʻohe contraindication, pono e hoʻohana koke ʻia ka heparin a i ʻole ka haʻahaʻa haʻahaʻa molecular heparin a i ʻole NOAC i ka hiki, a pono e hana ʻia ka cardioversion i ka manawa like.