服用华法令出血的处理

请问服用华法令出血后如何使用维生素K1，多大的剂量，什么时候停用维生素K1？糖皮质激素可以使用吗？维生素C 呢

•Major bleeding—stop warfarin; give phytomenadione (vitamin K1) 5–10 mg by slow intravenous injection; give dried prothrombin complex (factors II, VII, IX, and X—section 2.11), 30–50 units/kg or fresh frozen plasma 15 mL/kg (if dried prothrombin complex not available)

&#8226;INR > 8.0, no bleeding or minor bleeding—stop warfarin, restart when INR < 5.0; if there are other risk factors for bleeding give phytomenadione (vitamin K1) 500 micrograms by slow intravenous injection or 5 mg by mouth (for partial reversal of anticoagulation give smaller oral doses of phytomenadione e.g. 0.5–2.5 mg using the intravenous preparation orally); repeat dose of phytomenadione if INR still too high after 24 hours

&#8226;INR 6.0–8.0, no bleeding or minor bleeding—stop warfarin, restart when INR < 5.0

&#8226;INR < 6.0 but more than 0.5 units above target value—reduce dose or stop warfarin, restart when INR < 5.0

&#8226;Unexpected bleeding at therapeutic levels—always investigate possibility of underlying cause e.g. unsuspected renal or gastro-intestinal tract pathology


BNF的原文，如果需要翻译再讲。