低分子肝素钙联用哌拉西林钠他唑巴坦钠致重度血小板减少个案分析  

Severe Thrombocytopenia Induced by Low Molecular Weight Heparin Calcium Combined with Piperacillin Sodium and Tazobactam Sodium:A Case Report

作　　者：唐长征 姚威 唐莉[2] 李思光 TANG Changzheng;YAO Wei;TANG Li;LI Siguang(Bozhou Hospital of Traditional Chinese Medicine,Bozhou,Anhui,China 236800;Bozhou People's Hospital,Bozhou,Anhui,China 236800)

机构地区：[1]安徽省亳州市中医院,安徽亳州236800 [2]安徽省亳州市人民医院,安徽亳州236800

出　　处：《中国药业》2024年第16期140-143,共4页China Pharmaceuticals

摘　　要：目的为临床安全使用低分子肝素钙及哌拉西林钠他唑巴坦钠提供参考。方法回顾性分析亳州市中医院收治的1例低分子肝素钙联用哌拉西林钠他唑巴坦钠致重度血小板减少的老年男性糖尿病足患者的治疗过程。结果患者因右足溃烂1个月入院[入院时血小板计数(PLT)较高,为571×10^(9)/L],在常规予胰岛素降血糖的同时,根据尿细菌培养及药物敏感性试验结果,给予注射用哌拉西林钠他唑巴坦钠(4.5 g,静脉滴注,每8 h 1次)和低分子肝素钙注射液(4000 AⅩaIU,皮下注射),治疗12 d后PLT降至14×10^(9)/L(重度血小板减少),考虑与上述2种药物联用有关,停用4 d后,PLT升至52×10^(9)/L,6 d后PLT恢复正常。结论临床联用低分子肝素钙及哌拉西林钠他唑巴坦钠时应考虑导致重度血小板减少的可能性,应密切监测患者血常规及临床表现,及时处理。Objective To provide a reference for the safe use of low molecular weight heparin calcium and piperacillin sodium and tazobactam sodium in clinical practice.Methods The treatment process of an elderly male patient with diabetes foot suffering from severe thrombocytopenia induced by low molecular weight heparin calcium combined with piperacillin sodium and tazobactam sodium admitted to the Bozhou Hospital of Traditional Chinese Medicine was analyzed retrospectively.Results The patient was admitted to the hospital due to the right foot ulceration for one month,with a high platelet count(PLT)of 571×10^(9)/L at admission.He was given Piperacillin Sodium and Tazobactam Sodium for Injection(4.5 g,intravenous drip,once every 8 h)and Low Molecular Weight Heparin Calcium Injection(4000 AⅩaIU,subcutaneous injection)based on urine bacterial culture and drug sensitivity test while receiving routine insulin to lower blood glucose.After 12 d of treatment,the patient′s PLT decreased to 14×10^(9)/L(severe thrombocytopenia),which might be related to the combination of the above two drugs.After discontinuing the two drugs for 4 d,his PLT increased to 52×10^(9)/L,and returned to normal after 6 d.Conclusion When using low molecular weight heparin calcium combined with piperacillin sodium and tazobactam sodium in clinical practice,it should be considered that this may lead to severe thrombocytopenia.The patients′blood routine and clinical manifestations should be closely monitored,and the adverse drug reaction should be promptly treated.

关 键 词：哌拉西林钠他唑巴坦钠 低分子肝素钙 联合用药 血小板减少 糖尿病足 用药安全 药学监护 

分 类 号：R969.3[医药卫生—药理学] R558.2[医药卫生—药学]