一例冠状动脉介入术后合并肺栓塞应用抗栓药致消化道出血的药学监护

Pharmaceutical Care on One Case of Gastrointestinal Hemorrhage Caused by Anticoagulant Drugs in a Patient with Percutaneous Coronary Intervention Combined with Pulmonary Embolism

目的探讨临床药师如何对冠状动脉介入术后合并肺栓塞患者应用抗栓药时进行药学监护。方法通过研究该患者所使用的抗栓药,分析发生消化道出血的可能原因。结果四联应用抗凝及抗血小板药物是该患者出现消化道出血症状的主要原因。结论对于冠状动脉介入术后应用阿司匹林和氯吡格雷同时应用肝素和华法林指征患者,抗凝药物的应用应基于出血风险的评估,减少抗凝药种类等因素,并进行综合评估。

Objective To explore how clinical pharmacists to use antithrombotic drugs for patients with pulmonary embolism after percutaneous coronary intervention operation to carry out pharmaceutical care. Methods By studying the antithrombotic drugs used in the patient, the possible causes of gastrointestinal hemorrhage were analyzed. Results The application of anticoagulant and antiplatelet drugs in the quadruple is the main cause of the symptoms of gastrointestinal hemorrhage in this patient. Conclusion The application of anticoagulants should be based on the risk of bleeding and the types of anticoagulant drugs for patients with heparin and wafarin indication when aspirin and clopidogrel are applied after percutaneous coronary intervention.