1例子宫内膜癌术后应用甲地孕酮致深静脉血栓同时合并癫痫患者的用药分析

Analysis of deep venous thrombosis induced by megestrol in a patient with endometrial cancer and epilepsy

1例61岁女性患者,因子宫内膜癌术后,口服醋酸甲地孕酮分散片治疗(160 mg,每日2次),3个月后,患者出现左下肢深静脉广泛血栓,行下腔静脉滤器植入术及血栓抽吸术,术后给予肝素,并序贯口服抗凝治疗,期间患者同时服用卡马西平片(100 mg,每日2次),因卡马西平与多种抗凝药物存在相互作用,治疗方案将其调整为丙戊酸钠缓释片(500 mg,每日1次),抗凝药物选择利伐沙班片(20 mg,每日1次),术后患者随访情况良好,无血栓复发。

A 61 years old female was treated with megestrol（160 mg,twice a day）forendometrial cancer.Three months later,the patient developed extensive thrombosis in the deep vein of the left lower extremity,and inferior vena cava filter implantation and thrombus aspiration was performed.After operation,heparin and sequential oral anticoagulant therapy was given.During this period,the patient was also given carbamazepine tablets（100 mg,twice a day）.Because of the interaction between carbamazepine and a variety of anticoagulants,the treatment plan will be adopted.It was adjusted to sodium valproate sustained-release tablets（500 mg,once a day） and rivaroxaban tablets（20 mg,once a day） as anticoagulant.The patients were followed up well without thrombus recurrence.