冠心病老年患者抗栓治疗致消化道出血的病例分析  

Analysis of Senior Patient with Coronary Heart Disease Occurred Gastrointestinal Bleeding during Antithrombotic Therapy

作　　者：姚天赐[1] 于阗[1] YAO Tianci;YU Tian(Department of Pharmacy,The First Affiliated Hospital of Xiamen University,Fujian Xiamen 361022,China)

机构地区：[1]厦门大学附属第一医院药学部,福建厦门361022

出　　处：《中国医药导刊》2020年第12期874-877,共4页Chinese Journal of Medicinal Guide

摘　　要：目的:通过对1例冠心病老年患者抗栓治疗过程中发生严重出血的病例进行分析,提高对抗栓过程中出血风险的认识。方法:结合患者的病史、辅助检查、治疗过程,对发生出血可能的原因进行分析。结果:该患者发生出血可能的原因为:①该冠心病老年患者同时有胃溃疡史、高血压、心衰等多种基础疾病,可能在抗栓治疗中引起消化道出血。②在抗栓治疗中使用阿司匹林和氯吡格雷双联抗血小板可致消化道出血。③氯化钾缓释片对胃肠道具有刺激作用,可加重老年患者的消化道损伤,引起出血。结论:临床中对于老年患者的抗栓治疗更需谨慎,应充分评估抗栓治疗风险和获益,及时发现潜在的风险。Objective:To improve the recognition of bleeding risk in the antithrombotic process by analyzing a case of senior patient with coronary heart disease occurred gastrointestinal bleeding during the antithrombotic therapy.Methods:The possible causes of hemorrhage were analyzed combined with the medical history,laboratory tests report and treatment process of the patient.Results:The reasons of hemorrhage might be as follows:①The senior patient with coronary heart disease had the history of gastric ulcer,hypertension,heart failure and other basic diseases,which might induce gastrointestinal bleeding during in antithrombotic therapy.②Aspirin combined with clopidogrel dual antiplatelet therapy can cause gastrointestinal bleeding.③Potassium chloride sustained-release tablets have stimulatike effect on the gastrointestinal tract,can aggravate the digestive tract injury of elderly patients and cause bleeding.Conclusion:Clinical antithrombotic therapy should be more cautious in senior patients,the risks and benefits should be evaluated in order to find potential risks timely.

关 键 词：冠心病 抗血小板 出血 老年 

分 类 号：R573.2[医药卫生—消化系统]