What should I do if my prothrombin time is 42.8

The prothrombin time was significantly prolonged at 42.8 seconds, indicating abnormal coagulation function. A comprehensive intervention combining anticoagulant therapy, etiological investigation, vitamin K supplementation, liver function assessment, and hematology consultation is needed. May be caused by excessive warfarin, liver disease, vitamin K deficiency, disseminated intravascular coagulation, or genetic coagulation factor deficiency.

1. Anticoagulant therapy adjustment:

If caused by anticoagulants such as warfarin, medication should be immediately suspended and INR values monitored. When severe bleeding occurs, vitamin K antagonists can be used to reverse it, and if necessary, fresh frozen plasma can be infused to supplement clotting factors. Long term anticoagulation patients need to re evaluate their medication regimen, adjust the dosage, or switch to new oral anticoagulants.

2. Liver disease related treatment:

Liver diseases such as cirrhosis and hepatitis can lead to insufficient synthesis of coagulation factors. It is necessary to improve liver function, abdominal ultrasound and other examinations, and carry out liver protection treatment for the primary disease. Patients with severe liver failure may require infusion of prothrombin complex while preventing esophageal vein rupture bleeding.

3. Vitamin K supplementation:

Vitamin K deficiency caused by malnutrition or biliary obstruction requires intramuscular injection of 10mg of vitamin K, which can be improved within 3-5 days. Patients with neonatal hemorrhage need to urgently supplement vitamin K, and chronic diarrhea or antibiotic users also need to regularly monitor coagulation function.

4. DIC screening:

Diffuse intravascular coagulation is often accompanied by thrombocytopenia and fibrinogen reduction. It is necessary to check indicators such as D-dimer and FDP, and actively deal with triggers such as infection and trauma. The treatment includes primary disease control, anticoagulation, and alternative therapy. Severe cases require infusion of cryoprecipitate and platelets.

5. Genetic disease identification:

Genetic diseases such as hemophilia and coagulation factor II/V/X deficiency need to be diagnosed through coagulation factor activity testing. Patients with spontaneous bleeding need to receive regular infusion of concentrated clotting factor preparations, and prophylactic supplementation is required before surgery to avoid traumatic procedures. Patients with abnormal coagulation function should avoid vigorous exercise and trauma, and use a soft bristled toothbrush to reduce gum bleeding. Adding green leafy vegetables to the diet to supplement vitamin K, but warfarin users need to maintain a stable intake. Regularly monitor the four coagulation parameters, observe signs of bleeding such as skin bruising and nosebleeds, and women should pay attention to changes in menstrual flow. Long term anticoagulant therapy patients need to carry a medical warning card with them and proactively inform them of their medication history when seeking medical treatment.