头孢哌酮钠-舒巴坦钠致凝血功能异常的因素分析

Analysis on Factors Affecting Dysfunction of Blood Coagulation Caused by Cefoperazone Sodium-sulbactam sodium

目的:探讨头孢哌酮钠-舒巴坦钠对凝血功能的影响。方法:收集我院2016年6月—2017年6月使用头孢哌酮钠-舒巴坦钠的患者病例,观察用药前后凝血酶原时间(PT)、国际标准化比值(INR)、活化部分凝血活酶时间(APTT)及血小板计数(PLT)变化情况,并分析患者性别、年龄、肾功能、急性生理学和慢性健康状况评分Ⅱ(APACHEⅡ)、头孢哌酮钠-舒巴坦钠日剂量、疗程与凝血功能异常的相关性。结果:126例患者中出现凝血功能异常20例,发生率为15.8%;用药后PT、INR、APTT较用药前明显延长,差异有统计学意义(P <0.05),PLT无明显变化(P> 0.05);停药或给予维生素K_1均能恢复凝血功能;正常组APACHEⅡ评分低于异常组,差异有统计学意义(P <0.05)。结论 :头孢哌酮钠-舒巴坦钠可对部分患者特别是危重患者的凝血功能造成影响,停药或给予维生素K_1可使凝血功能恢复。

Objective: To investigate the effect of cefoperazone sodium-sulbactam sodium on coagulation function. Methods: The patients who underwent cefoperazone sodium-sulbactam sodium treatment in our hospital from June 2016 to June 2017 were collected. The changes of prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT) and platelet count (PLT) before and after treatment were observed, and the correlation of dysfunction of blood coagulation with sex, age, renal function, acute physiology and chronic health status scoreⅡ (APACHEⅡ) and daily dose of cefoperazone sodium-sulbactam sodium was analyzed. Results: 20 cases of coagulation dysfunction occurred in 126 patients, and the incidence rate was 15.8%. The PT, INR and APTT after administration were significantly longer than those before administration, and the difference was statistically significant (P<0.05), while PLT had no obvious change (P>0.05). Withdrawal or administration of vitamin K1 could restore coagulation function. The APACHEⅡ in the normal group were lower than those in the abnormal group, and the difference was statistically significant (P<0.05). Conclusion: Cefoperazone sodiumsulbactam sodium can affect the coagulation function of some patients, especially critically ill patients, and withdrawal or administration of vitamin K1 can restore coagulation function.