1例支气管扩张患者PCI术后咯血的病例分析

Analysis of hemoptysis after PCI in one patient with bronchiectasis

大咯血是支气管扩张严重的并发症,当患者合并其他疾病,同时存在出血与血栓风险时,临床治疗更加困难。本文就1例支气管扩张经皮冠状动脉介入治疗(PCI)术后大咯血的病例,介绍了临床药师参与治疗方案确定的过程,并对患者的止血和抗栓治疗方案进行分析,目的是探讨如何为此类特殊患者选择恰当的止血药物以及确定合适抗栓治疗策略。结果发现普鲁卡因对PCI术后患者的大咯血可取得良好的止血效果,并减少不良反应的发生;同时缩短双联抗血小板疗程,采用阿司匹林单抗治疗,可避免出血与血栓事件的发生。

Massive hemoptysis is a serious complication of bronchiectasis. When patients suffering from other complications, the risk of hemorrhage and thrombosis being coexistent, it is more difficult to treat in clinic. This article presents a case of massive hemoptysis after percutaneous coronary intervention（PCI） in a patient with bronchiectasis. The process of the clinical pharmacist participating in therapeutic regimen was introduced and the treatment scheme of hemostasis and antithrombosis was analyzed in order to explore how to selecte appropriate hemostatic drugs and determine the suitable antithrombotic treatment strategy in these special patients. The results showed that procaine can obtain good hemostasis in patients with severe hemoptysis after PCI, and reduce the incidence of adverse reactions; at the same time, it shortens the dual antiplatelet treatment course. The use of aspirin as a monoclonal antibody treatment can prevent the occurrence of bleeding and thrombotic events.