1例注射用白眉蛇毒血凝酶致凝血障碍药学监护实践及文献分析  

Pharmaceutical Care Practice and Literature Analysis of a Case of Coagulation Disorder Induced by Hemocoagulase for Injection

作　　者：苗会青 苏东兰 陈小欣 MIAO Huiqing;SU Donglan;CHEN Xiaoxin(Center for ADR Monitoring of Hainan Province,Haikou,Hainan,China 570216;Center for ADR Monitoring of Bo'ao Pilot Zone of Hainan Province,Haikou,Hainan,China 570216;Hainan Women and Children's Medical Center,Haikou,Hainan,China 570206;Haikou Center for ADR Monitoring of Hainan Province,Haikou,Hainan,China 570311)

机构地区：[1]海南省药品不良反应监测中心,海南海口570216 [2]海南省博鳌先行区药品不良反应监测中心,海南海口570216 [3]海南省妇女儿童医学中心,海南海口570206 [4]海南省海口市药品不良反应监测中心,海南海口570311

出　　处：《中国药业》2022年第14期119-122,共4页China Pharmaceuticals

基　　金：海南省自然科学基金面上项目[821MS0818];海南省省级临床医学中心建设项目[琼卫医函〔2021〕75号]。

摘　　要：目的促进临床安全合理使用注射用白眉蛇毒血凝酶。方法临床药师参与1例凝血障碍患儿的临床诊疗过程,结合相关文献资料,综合患儿凝血障碍特征和用药史,判断为注射用白眉蛇毒血凝酶使用过久(共间断使用19 d),并建议停用。结果医师接受临床药师的建议,给予输注冷沉淀、新鲜冰冻血浆以及维生素K1、氨甲环酸、酚磺乙胺止血后出血得到控制。结论较长时间使用注射用白眉蛇毒血凝酶,即使在正常给药剂量下也可能引起纤维蛋白原浓度下降而导致出血,临床应予以警惕,注意监测凝血功能,保证患者的用药安全。Objective To promote the safe and rational use of Hemocoagulase for Injection.Methods The clinical pharmacist participated in the clinical diagnosis and treatment of a child with coagulation disorder.Based on the relevant literature and the characteristics of coagulation disorder and the medication history of the child,the clinical pharmacist judged that the coagulation disorder was induced by the prolonged application of Hemocoagulase for Injection,and suggested that it should be stopped.Results The doctor accepted the clinical pharmacist's advice,and the bleeding was controlled after the child was transfused with cryoprecipitate,fresh frozen plasma,vitamin K1,tranexamic acid and etamsylate for hemostasis.Conclusion Prolonged application of Hemocoagulase for Injection may induce bleeding due to a decrease in fibrinogen concentration even at a normal dose.Clinic should be alert to monitoring coagulation function for the medication safety of patients.

关 键 词：注射用白眉蛇毒血凝酶 凝血障碍 出血 纤维蛋白原 药品不良反应 药学监护 临床药师 

分 类 号：R969.3[医药卫生—药理学] R973[医药卫生—药学]