摘要
目的探讨妊娠期及产褥期并发严重肾功能不全患者的抗凝治疗方案,为临床该类患者提供抗凝用药参考。方法临床药师通过查阅指南、专家共识、复习妊娠期及哺乳期抗凝药物的安全用药,以及严重肾功能不全患者抗凝药物剂量调整的相关文献,参与1例慢性高血压合并子痫前期并发严重肾功能不全患者术后抗凝方案的制定。结果临床药师提供医师该患者肝素(5000 U q12h皮下注射)抗凝方案并进行APTT监护,医师采纳,患者无血栓发生,经治疗好转出院。结论对于孕产妇并发严重肾功能不全需预防静脉血栓时,肝素是个较适合的选择抗凝用药,使用过程中监测APTT。
OBJECTIVE To explore the anticoagulation treatment plan for patients with severe renal insufficiency during pregnancy and puerperium,and to provide anticoagulation medication reference for such patients.METHODS Clinical pharmacists participated in the formulation of postoperative anticoagulation plan for a patient with chronic hypertension complicated with preeclampsia and severe renal insufficiency by consulting the guidelines,expert consensus,reviewing the safe use of anticoagulants during pregnancy and lactation,and the relevant literature on the dose adjustment of anticoagulants in patients with severe renal insufficiency.RESULTS The clinical pharmacist provided the physician with the anticoagulant regimen of heparin(5000 U q12h subcutaneous injection)and performed APTT monitoring.The physician adopted the anticoagulant regimen.The patient was free of thrombosis and discharged after treatment.CONCLUSION For pregnant and lying-in women with severe renal insufficiency who need to prevent venous thrombosis,heparin is a more suitable choice of anticoagulation drugs,and APTT is monitored during use.
作者
窦妹
梅峥嵘
施胜英
刘少志
殷锦锦
DOU Mei;MEI Zhengrong;SHI Shengying;LIU Shaozhi;YIN Jinjin(Department of Pharmacy,The Third Affiliated Hospital of Guangzhou Medical University,Guangzhou,Guangdong 510150,China;Department of Pharmacy,Xinyi Maternal and Child Health Hospital,Xinyi,Guangdong 525300,China)
出处
《今日药学》
CAS
2022年第12期939-943,共5页
Pharmacy Today
基金
广东省医院药学研究基金(2021A29,2016MZ05)。
关键词
慢性高血压
子痫前期
严重肾功能不全
静脉血栓
抗凝
chronic hypertension
preeclampsia
severe renal insufficiency
venous thrombosis
anticoagulation
