PCI术后急性肾损伤合并VTE和HIT的透析患者抗栓治疗的药学监护

Pharmaceutical care for antithrombotic therapy in dialysis patients with acute kidney injury combined with VTE and HIT after PCI

临床药师参与经皮冠状动脉介入治疗(PCI)术后急性肾损伤合并静脉血栓栓塞症(VTE)及肝素诱导血小板减少症(HIT)患者的治疗,及时查阅指南及文献并结合患者病情特点,探讨个体化抗栓治疗方案。合并VTE时在阿司匹林和氯吡格雷基础上联合阿哌沙班抗栓治疗,未发生严重的出血或血栓栓塞等不良事件。可疑HIT时及时停用肝素类药物,血小板计数恢复正常。抗栓治疗过程中对患者进行药学监护,保障患者用药安全。

Clinical pharmacists participated in the treatment of patients with acute kidney injury complicated with venous thromboembolism(VTE)and heparin-induced thrombocytopenia(HIT)after percutaneous coronary intervention(PCI),consulted the guidelines and literature timely and provided individualized antithrombotic therapy according to the characteristics of the patient's condition.When combined with VTE,apixaban was used in addition to aspirin and clopidogrel for antithrombotic therapy,and no serious adverse events such as bleeding or thromboembolism occurred.When suspected HIT,heparin were discontinued in time,and platelet count returned to normal.Pharmaceutical care was given to patients during antithrombotic therapy to ensure the safety of patients'medication.