急性冠脉综合征合并慢性肾脏病患者冠状动脉旁路移植术围术期出血与血栓治疗矛盾的平衡管理

Perioperative antithrombotic therapy for coronary artery bypass grafting in patients with acute coronary syndrome complicated with chronic kidney disease

目的评价1例急性冠脉综合征合并慢性肾功能不全患者冠状动脉旁路移植术围术期的抗栓治疗方案。方法查阅相关指南及文献综述中急性冠脉综合征合并慢性肾脏病患者冠状动脉旁路移植术围术期治疗不同阶段的抗栓处理方案。结果临床药师参与药物治疗过程,制定了安全有效的抗栓方案。结论应充分评估患者的血栓和出血风险,制定个体化抗栓方案。

Objective To evaluate the antithrombotic regimen for coronary artery bypass grafting in one patient with acute coronary syndrome complicated with chronic renal insufficiency. Methods Relevant guidelines and literatures were consulted. Perioperative antithrombotic therapy for different stages of treatment for coronary artery bypass grafting in patients with acute coronary syndrome complicated with chronic kidney disease were reviewed. Results Clinical pharmacists were involved in the establishment of safe and effective anti-thrombosis therapy. Conclusion The thrombosis and bleeding risks should be evaluated adequately and individually before developing antithrombotic regimens.