地屈孕酮与氨甲环酸联用致下肢深静脉血栓形成患者的药学监护

Pharmaceutical care for a patient with deep venous thrombosis in the lower extremity caused by dydrogesterone combined with tranexamic acid

1例多囊卵巢综合征和子宫内膜病变宫腔镜术后出血患者,口服地屈孕酮片(20 mg bid 7 d、10mg tid 4 d)11 d和氨甲环酸片(1 g tid)5 d治疗。用药第10日时,患者出现下肢深静脉血栓,停药并行"下腔静脉取栓术及下腔静脉滤器植入术",同时启动低分子肝素、利伐沙班抗凝治疗。术后,患者患肢肿胀、疼痛减轻,下肢深静脉血管再通,考虑患者子宫仍有出血,予出院后口服小剂量利伐沙班10mg qd继续抗凝治疗,定期随访调整利伐沙班剂量。

A patient had intrauterine hemorrhage due to polycystic ovary syndrome and endometrial lesions was given.Oral dydrogesterone tablets(20 mg bid 7 d,10 mg tid 4 d)for 11 days and tranexamic acid tablets(1 g tid)for 5 days treatment were provided.On the 10 th day of treatment,the patient developed deep venous thrombosis in the lower extremity,and discontinued the drug before inferior vena cava thrombectomy and inferior vena cava filter implantation,and started low-heparin and rivaroxaban anticoagulant therapy meanwhile.After the operation,the patient’s limbs were swollen,the pain was relieved,and the deep veins of the lower extremities were recanalized.Considering that the patient still had uterus bleding,oral administration of low-dose rivaroxaban 10 mg qd was offered anticoagulant therapy after the discharge,and regular adjustment of rivaroxaban dose was followed-up.