1例PCI术后双联抗血小板治疗致消化道出血的病例分析

Case Analysis of Gastrointestinal Bleeding Caused by Dual Anti-platelet Therapy after PCI

目的探讨双联抗血小板治疗(DAPT)致消化道出血的机制及抗血栓再治疗的时机与联合质子泵抑制剂方案的选择。方法临床药师为1例经皮冠状动脉介入治疗(PCI)术后患者DAPT致消化道出血病例调整后续药物治疗方案。结果建议继续使用双联抗血小板治疗联合PPIs用药,同时监测患者再出血风险。结论 DAPT致消化道出血事件后,临床药师评估患者消化道再出血风险和血栓风险,提出用药建议,具有重要意义。

OBJECTIVE To discuss the mechanism of gastrointestinal bleeding caused by DAPT and timing of antithrombotic retreatment and selection of combined PPIs. METHODS Clinical pharmacists adjusted the follow-up medication regimen for the patient occurred digestive tract hemorrhage caused by DAPT after PCI. RESULTS Clinical pharmacist suggesed continue using dual antiplatelet therapy combined with PPIs,and monitoed the risk of rebleeding. CONCLUSION It is of great significance for clinical pharmacist to evaluate the risk of gastrointestinal rebleeding and thrombosis and to weigh the benefits after a DAPT-induced gastrointestinal hemorrhage event.