血栓弹力图指导支架内血栓后不稳定心绞痛治疗1例及文献复习

The Treatment under the Guidance of Thromboelastography of One Case Report about Stent Thrombosis after Percutaneous Coronary Intervention with Discussion On the Application of Thromboelastography

目的:探讨在血栓弹力图监测血小板抑制率的情况下,调整氯吡格雷及阿司匹林用量,治疗冠心病、PCI术后支架内再发血栓患者的临床意义。方法:报告中国人民解放军总医院1例支架内亚急性血栓患者的临床资料并复习相关文献,对其临床表现、诊断、在血栓弹力图指导下的治疗进行分析。结果:1例支架内亚急性血栓患者经治疗病情好转出院,出院后继续调整氯吡格雷及阿司匹林用量,达到满意血小板抑制率,患者症状消失。结论:冠状动脉介入治疗后发生支架内血栓的患者,应用血栓弹力图指导氯吡格雷及阿司匹林用量,可达到令人满意的血小板抑制率,并防止出血情况发生。

Objective： To discuss the clinical significance of adjusting amount of clopidogrel and aspirin under the guidance of throm-boelastography on the patients with the sub-acute stent thrombosis after the percutaneous coronary intervention.Methods： Report one case of acute stent thrombosis in the General Hospital of People’s Liberation Army,discuss the clinical data and clinical manifestations,analyze the treatment under the guidance of thromboelastography.Results： 1 case of sub-acute stent thrombosis was turned better and discharged from hos-pital after treatment,and continued to have adjusted amount of clopidogrel and aspirin under the guidance of thromboelastography,in order to achieve satisfactory platelet inhibition,until symptoms disappeared.Conclusion： The patients with sub-acute stent thrombosis after percuta-neous coronary intervention can achieve satisfactory inhibition rate of platelets and prevent from bleeding by adjusting amount of clopidogrel and aspirin under the guidance of thromboelastography.