1例心血管危重症患者动脉置管冲洗用肝素诱发HIT可能的识别与分析

Possible identification and analysis of heparin-induced thrombocytopenia(HIT)arising from heparin flushes in a patient with critical cardiovascular disease

目的:探讨心血管危重症患者血小板减少的相关药物因素及风险管理。方法:临床药师对1例心血管危重症患者用药情况进行梳理,基于已知药品不良反应类型、血小板计数变化趋势及时间关联性,并结合文献检索,综合分析和鉴别可能引起血小板减少的药物。结果:患者出现的血小板减少与动脉置管冲洗用肝素之间相关性最大。结论:针对动脉置管的心血管危重症患者需警惕冲洗用肝素诱发HIT的可能性,应加强用药风险管理。

Objective:To investigate the drug factors and risk management related to thrombocytopenia in a patient with critical cardiovascular disease.Methods:Clinical pharmacist reviewed the status of her medication and identified the drugs that may cause her thrombocytopenia based on the known types of adverse drug reaction,changes of platelet count,time correlation and literature research.Results:The greatest correlation was found between thrombocytopenia and heparin flushes for arterial catheterization.Conclusion:It is necessary to pay attention to the possibility of heparin-induced thrombocytopenia(HIT)arising from heparin flush and strengthen medication risk management for patients with critical cardiovascular disease.