1例冠状动脉旁路移植术后肝素诱导血小板减少症患者药物治疗与药学监护

doi:10.19803/j.1672-8629.2021.03.17

中国药物警戒 ›› 2021, Vol. 18 ›› Issue (3): 284-288.
DOI: 10.19803/j.1672-8629.2021.03.17

1例冠状动脉旁路移植术后肝素诱导血小板减少症患者药物治疗与药学监护

张永娜^1,2, 张艳娇³, 赵莉^2,*, 韩永新⁴

¹郑州大学附属肿瘤医院药学部,河南郑州 450008;
²中日友好医院药学部,北京 100029;
³云南省第一人民医院,云南昆明 650032;
⁴中日友好医院心脏血管外科,北京 100029

出版日期:2021-03-15 发布日期:2021-04-06
通讯作者: ^*赵莉,女,硕士,副主任药师,抗凝治疗专业临床药学。E-mail：apno12005@126.com
作者简介:张永娜,女,硕士,主管药师,抗凝治疗专业临床药学。

One Case of Drug Treatment and Pharmaceutical Care in Patients with HIT after Coronary Artery Bypass Grafting

ZHANG Yongna^1,2, ZHANG Yanjiao³, ZHAO Li^2,*, HAN Yongxin⁴

¹Deptartment of Pharmacy, Affiliated Tumor Hospital of Zhengzhou University, Zhengzhou Henan 450008, China;
²Deptarment of Pharmacy, China -Japan Friendship Hospital, Beijing 100029, China;
³Dept. of Pharmacy, The First People's Hospital of Yunnan Province, Kunming Yunnan 650032, China;
⁴Department of Cordiovascular Surgery, China-Japan Friendship Hospital, Beijing 100029, China

Online:2021-03-15 Published:2021-04-06

摘要/Abstract

摘要： 目的探讨1例冠状动脉旁路移植术后发生肝素诱导血小板减少症患者治疗方案的制订与药学监护。方法检索近年来国内外相关文献,结合本病例进行药品不良反应相关性评价,协助临床医生制订个体化治疗方案,包括抗凝药物的选择、抗菌药物使用的干预及出院后华法林的剂量调整,对患者实施全程化的药学监护。结果患者病情稳定,出院时血小板已恢复至正常,国际标准化比值已达标,住院期间未见明显栓塞及出血。结论临床药师协助医师制订及优化患者全程治疗方案与药学监护,有助于保证用药的安全、有效、经济。

关键词: 肝素, 冠状动脉旁路移植术, 肝素诱导血小板减少症, 药学监护, 药品不良反应

Abstract: Objective To investigate the formulation and pharmaceutical care of a case of heparin- induced thrombocytopenia after coronary artery bypass grafting Methods The related literature were searched in recent years, the correlation evaluation of adverse drug reaction was carried out in combination with this case to assist clinicians to formulate individualized treatment plans, including the selection of anticoagulant drugs, the intervention of antibacterial drug use and the dose adjustment of warfarin sodium after discharge, and to give the patients the whole course of pharmaceutical care. Results The patient was discharged from hospital stably, platelet returned to normal, the international normalized ratio reached the standard, and no obvious embolism and bleeding were found during hospitalization. Conclusion Clinical pharmacists assist doctors to formulate and optimize the whole course treatment plan and pharmaceutical care to ensure the safety, effectiveness and economy of drug use.

Key words: heparin, coronary artery bypass grafting, heparin-induced thrombocytopenia, pharmacy care, adverse drug reaction

中图分类号:

R944.11

张永娜, 张艳娇, 赵莉, 韩永新. 1例冠状动脉旁路移植术后肝素诱导血小板减少症患者药物治疗与药学监护[J]. 中国药物警戒, 2021, 18(3): 284-288.

ZHANG Yongna, ZHANG Yanjiao, ZHAO Li, HAN Yongxin. One Case of Drug Treatment and Pharmaceutical Care in Patients with HIT after Coronary Artery Bypass Grafting[J]. Chinese Journal of Pharmacovigilance, 2021, 18(3): 284-288.

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1例冠状动脉旁路移植术后肝素诱导血小板减少症患者药物治疗与药学监护

One Case of Drug Treatment and Pharmaceutical Care in Patients with HIT after Coronary Artery Bypass Grafting

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