首选:●开始Warfarin 2.5-5 mg PO Daily(最大初始剂量= 5 mg)。请勿使用加载剂量。● Turn argatroban infusion off and begin fondaparinux at treatment doses ○ Weight < 50 kg: 5 mg SQ ○ Weight 50-100 kg: 7.5 mg SQ ○ Weight > 100 kg: 10 mg SQ ● After a minimum 5-day overlap of fondaparinux and warfarin, discontinue fondaparinux when the INR is between 2-3 and continue with warfarin monotherapy替代:●开始华法林2.5-5毫克PO每天(最大初始剂量= 5 mg)。请勿使用加载剂量。与Argatroban重叠至少5天。 ●如果argatroban剂量≤2mcg/kg/kg/minune and inr> 4,请停止输注并在停止输注后4小时获得INR与Argatroban重叠至少5天。●如果argatroban剂量≤2mcg/kg/kg/minune and inr> 4,请停止输注并在停止输注后4小时获得INR