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1例紫癜性肾炎合并下肢深静脉血栓形成患儿的抗栓治疗分析与药学监护
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| 篇名： | 1例紫癜性肾炎合并下肢深静脉血栓形成患儿的抗栓治疗分析与药学监护 |
| TITLE： | Antithrombotic therapy and pharmaceutical care of a child with purpura nephritis complicated with lower extremity deep venous thrombosis |
| 摘要： | 目的 为下肢深静脉血栓形成（DVT）患儿抗栓治疗方案的制定提供参考。方法临床药师参与1例紫癜性肾炎合并下肢DVT患儿的抗栓治疗过程，为患儿制定个体化给药方案。考虑患儿下肢DVT经抗凝治疗后未缓解再次入院，临床药师与临床医师联合会诊后建议继续使用依诺肝素钠注射液30mg，q12h，皮下注射，抗凝治疗，同时行置管溶栓治疗和溶栓药物治疗（静脉泵入注射用尿激酶20万单位，qd）；关注患儿不良反应发生情况，监测凝血指标变化；对于出院后的长期抗凝治疗，建议口服利伐沙班片10mg，qd，并根据患儿体重变化调整药物剂量。结果临床医师采纳建议。患儿经治疗后凝血指标恢复正常，下肢DVT症状明显好转，且出院后未出现出血及其他血栓事件。结论临床药师依据药学专业知识协助临床医师为患儿制定个体化的抗栓治疗方案，有助于保障儿童用药的有效性和安全性。 |
| ABSTRACT： | OBJECTIVE To provide a reference for the formulation of the antithrombotic treatment regimen of children with lower extremity deep venous thrombosis （DVT）. METHODS The clinical pharmacist participated in the antithrombotic treatment of a child with purpura nephritis complicated with lower extremity DVT and formulated an individualized dosing plan for the child. Considering that the child was readmitted to the hospital when DVT of the lower extremities did not relieve after anticoagulation therapy， it was recommended that thrombolytic therapy （Enoxaparin sodium injection 30 mg， q2 h， i.d.） be initiated after joint consultation by clinical pharmacists and physicians； catheter thrombolysis and thrombolytic drug therapy were simultaneously performed （intravenous infusion of 200 000 units of Urokinase for injection， per day）； great attention should be paid to the occurrence of adverse drug reactions in children， and the changes in coagulation indexes of the children should be monitored. For long-term anticoagulation therapy after discharge， clinical pharmacists recommended oral Rivaroxaban tablets 10 mg， qd， and adjusted the dose according to the weight change of the child. RESULTS The clinician adopted the pharmacist’s recommendations. After drug thrombolytic therapy， the child’s coagulation indicators returned to normal， the symptoms of lower extremity DVT improved significantly， and there were no adverse events of bleeding or other thrombotic events after discharge. CONCLUSIONS Clinical pharmacists can assist clinicians in formulating individualized treatment plans for children based on their expertise in pharmacy to ensure the rationality of medication use in children， which helps ensure the effectiveness and safety of medication for children. |
| 期刊： | 2024年第35卷第20期 |
| 作者： | 刘维婷；李波霞；常耀文 |
| AUTHORS： | LIU Weiting，LI Boxia，CHANG Yaowen |
| 关键字： | 儿童；下肢深静脉血栓形成；抗栓治疗；临床药师；药学监护 |
| KEYWORDS： | children； lower extremity deep venous thrombosis； antithrombotic therapy； clinical pharmacist； pharmaceutical care |
| 阅读数： | 10 次 |
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