2011—2018年鄂东医疗集团4家医院头孢菌素类药品致成人凝血功能异常的相关因素分析

Analysis of relative factors for coagulation abnormalities induced by cephalosporin in adults patients in four hospitals of Edong Medical Group from 2011 to 2018

目的分析头孢菌素类药品导致成人凝血功能异常的相关因素,为临床预防和治疗不良反应(ADR)提供参考。方法回顾分析2011-2018年黄石市中心医院、黄石市普爱医院、黄石市中医医院和黄石市妇幼保健院收集的271例头孢菌素类药物致成人凝血功能异常患者的临床资料、干预措施及预后情况,调查患者性别、年龄、原患疾病、合并基础疾病、联合用药、头孢菌素类药物名称及累积用药时间等相关因素,数据采用采用SPSS 20.0软件进行统计分析。结果头孢菌素类药物致凝血功能异常例数占总ADR的例数的构成比呈上升趋势,从16.06%上升至22.76%;共涉及12种头孢菌素类药物,排序前3位的药物分别为头孢哌酮舒巴坦、头孢美唑和头孢曲松。合并低蛋白血症、肾功能不全、联用影响凝血功能药物及累积用药>5 d是头孢菌素类药物致成人凝血功能异常的危险因素。所有患者经停药、对症干预等措施后凝血功能恢复正常,未出现大出血及死亡病例。结论对于合并出血危险因素的患者在使用头孢菌素类药物期间应严密监测凝血功能,及时发现凝血功能异常与出血倾向,预防致死性出血事件发生。

Objective To investigate relative factors of coagulation abnormalities induced by cephalosporin in adults patients in a hospital, and provide references for clinical prevention and treatment adverse drug reaction(ADR). Methods The clinical data,interventions and prognosis of 271 adults patients with coagulation abnormalities induced by cephalosporin in Huangshi Central Hospital, Huangshi Puai Hospital, Huangshi Traditional Chinese Medicine Hospital, Huangshi Maternal and Child Health Hospital from 2011 to 2018 were retrospectively analyzed. Investigate factors include gender, age, primary disease, underlying disease,combination, cephalosporin name and cumulative medication time. The data were analyzed by SPSS 20.0 software. Results From2010 to 2018, the composition ratio of coagulation abnormalities induced by cephalosporin in adults patients accounting for the total number of ADR cases was increasing, and the composition ratio increased from 16.06% to 22.76%;A total of 12 cephalosporins were involved, and the top 3 drugs were Cefoperazone/sulbactam, Cefmetazole and Ceftriaxone. Combination of hypoproteinemia,renal insufficiency, combined coagulation drugs and medication >5 d were risk factors for coagulation abnormalities induced by cephalosporin in adults. After withdrawal of drugs and symptomatic intervention, the coagulation function of all patients returned to normal, and no hemorrhage or death occurred. Conclusion For patients with risk factors for coagulation abnormalities should be closely monitored coagulation during the use of cephalosporins. Timely detection of coagulation abnormalities and bleeding tendency should be detected in time to prevent fatal bleeding.