结肠癌合并心房颤动继发下肢深静脉血栓形成患者抗凝治疗的药学实践

Pharmacy Practice of Anticoagulant Therapy in Patients with Colon Cancer and Deep Venous Thrombosis of Lower Extremities Secondary to Atrial Fibrillation

目的:探讨临床药师在1例结肠癌合并心房颤动(简称房颤)继发下肢深静脉血栓形成(DVT)患者抗凝治疗过程中的作用。方法:临床药师通过针对1例抗凝期间出现便血的结肠癌合并房颤继发下肢DVT患者的抗凝方案,查阅相关文献资料进行抗栓分析,根据患者的实际病情提出个体化用药建议。结果:患者下消化道出血和下肢DVT症状均得到有效控制,予以出院。结论:临床药师结合患者疾病具体进展情况,全程参与抗凝方案的制定并进行药学监护与跟踪随访,以确保临床用药的安全性和有效性。

Objective:To explore the role of clinical pharmacists in the anticoagulant treatment of one patient with colon cancer and deep venous thrombosis(DVT)of lower extremities secondary to atrial fibrillation.Methods:Upon analyzing the anticoagulation regimen for one patient with colon cancer and DVT of lower extremities secondary to atrial fibrillation who experienced haematochezia during anticoagulant treatment,and consulting relevant literature,the clinical pharmacists provided advice on individualized treatment in light of the patient's condition.Results:The patient's lower gastrointestinal haemorrhage and DVT of lower extremities were effectively controlled and the patient was discharged.Conclusion:The safety and effectiveness of clinical medication is assured by thorough participation of the clinical pharmacists in the patient's treatment,from development of the anticoagulant treatment regimen to pharmaceutical care,safety monitoring and follow-up.