Treatment
（1）Low molecular weight heparin：（doesn't need monitoring of APTT）
①Enoxaparin：1mg/kg SC once 12 hours or 1.5mg/kg SC OD（administer at same time each day）.Initate warfarin same day；continue enoxaparin for 3～5 days.
Warning：adjusting dose if creatinine clearance＜30 mL/min and reduced body weight（women＜45 kg，men＜57 kg）.
②Unfractionated heparin，s.c.or i.v（if possible monitoring APTT）：
s.c.：250 U/kg SC followed by 250 U/kg BID（50 kg=12.500 IU；60 kg=15.000 IU，BID）.
Iv.：Bolus of 5000 IU i.v.，then perfusor 500 IU/mL at 2～3 mL/h.
warning：heparin induced thrombocytopenia 1～2 day after initiation，monitor FBC（platelets）half-life 4～6 hours，in case of hemorrhage stop drug.Initiate warfarin same day，continue heparin for 3～5 days.
（2）warfarin（vit k antagonist）：oral tablets at 1 mg，2.5 mg available.
Warning：Major risk of overdosage is hemorrhage，educate patient on signs of bleeding（gum，GI，hematuria）.Contraindicated in pregnancy！Many interactions，drugs as Aspirin，alcohol，phenytoin，Phenobarbital and others may potentiate the effect.Top 3～5 days before surgery and anticoagulate with heparin instead.Signs of bleeding：discontinue warfarin，give Vitamin k 10mg p.o.or i.v..Severe hemorrhage：fresh frozen plasma.(https://www.daowen.com)
Duration of therapy：first episode is 3 months（if transient cause）or 6 months in chronic disease.recurrent episodes is at least one year.
Abbreviations
CHF（congestive heart failure）：充血性心衰
INR（international normalized ratio）（prothrombin）：国际标准化比率（凝血素）
BID：一日2次
S.C（subcutaneous）：皮下注射
IU（international unit）：国际单位
APTT（activated partial thromboplastin time）：活化部分凝血活酶时间
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