1例冠心病PCI术后伴上消化道出血患者的药学监护

Pharmaceutical care for one case of upper gastrointestinal bleeding after PCI of atherosclerotic cardiovascular diseases

目的对1例冠状动脉粥样硬化性心脏病经皮冠状动脉介入治疗(Percutaneous coronary intervention,PCI)术后规律使用双联抗血小板治疗致上消化道出血的患者进行药学监护,为临床用药提供参考。方法临床药师通过参与1例冠心病PCI术后双联抗血小板致上消化道出血、同时伴有痛风患者的药物治疗,从多角度进行监护,分析治疗方案,提出用药调整,并对全程用药进行干预及优化。结果通过临床药师的干预,患者上消化道出血情况好转,临床预后改善,避免了潜在的药物相互作用,解决了临床用药的矛盾。结论药学监护可使患者接受精准药学服务,提高患者的药物治疗水平,降低不良反应的发生率,为临床用药提供保障。

Objective To give pharmaceutical care for a patient with upper gastrointestinal bleeding caused by dual antiplatelet therapy after percutaneous coronary intervention(PCI)for atherosclerotic cardiovascular diseases,and to provide a reference for clinical use.Methods By participating in the pharmacological treatment for a patient with upper gastrointestinal bleeding and gout after PCI,the clinical pharmacist monitored the patient from multiple perspectives,analyzed the treatment plan,proposed medication adjustments,and intervened and optimized the entire medication regimen.Results Through the intervention of clinical pharmacists,the upper gastrointestinal bleeding and the clinical prognosis of the patient were improved,potential drug interactions were avoided,and the contradiction of clinical medication was resolved.Conclusion Pharmaceutical care enables patients to receive precision pharmaceutical services,improves their drug treatment level,reduces the occurrence of adverse reactions,and provides guarantee for clinical medication.