1例TAVI术后突发卒中患者抗栓治疗分析
Analysis of Antithrombotic Therapy in one Patient with Sudden Stroke af-ter TAVI
高年婷 1张锋忠 2李波霞 3陈万强4
作者信息
- 1. 青海省交通医院药剂科,青海西宁 810000;兰州大学第一医院药剂科,甘肃兰州 730000
- 2. 青海省交通医院药剂科,青海西宁 810000
- 3. 兰州大学第一医院药剂科,甘肃兰州 730000
- 4. 兰州大学第一医院康复科,甘肃兰州 730000
- 折叠
摘要
目的 分析讨论房颤合并TAVI术后脑卒中抗栓治疗策略.方法 临床药师参与1 例67 岁男性主动脉瓣重度狭窄合并持续性心房颤动患者TAVI术后突发急性缺血性脑卒中,经充分评估患者卒中分型(NIHSS评分4 分)及出血风险(HAS-BLED评分3 分)后制定抗栓方案,停用DAPT,换用利伐沙班(20 mg,po,qd)长期抗凝治疗.结果 临床药师通过查阅文献及循证证据,结合患者临床情况,对抗栓治疗策略及药物的选择提出建议,患者病情得到有效控制,未再发缺血相关症状,无出血倾向,服药依从性良好.结论 临床药师在开展工作期间,应熟练掌握抗栓药物特点,以及不同情况下抗栓治疗策略,结合患者个体情况协助医师制定个体化治疗方案,进一步提高临床药物治疗的有效性和安全性.
Abstract
OBJECTIVE To analyze and discuss the antithrombotic therapy strategy for stroke after TAVI in pa-tients with atrial fibrillation.METHODS Clinical pharmacists participated in a 67-year-old male patient with severe aortic stenosis and persistent atrial fibrillation who had a sudden acute ischemic stroke after TAVI.After fully assess-ing the patient's stroke type(NIHSS score 4 points)and bleeding risk(HAS-BLED score 3 points),the antithrom-botic regimen was formulated,DAPT was stopped,and rivaroxaban(20 mg,po,qd)was used for long-term anticoagu-lant therapy.RESULTS Through literature review and evidence-based evidence,combined with the patient's clini-cal situation,clinical pharmacists put forward suggestions on the selection of antithrombotic therapy strategies and drugs.The patient's condition was effectively controlled,there was no recurrence of ischemia-related symptoms,no bleeding tendency,and the medication compliance was good.CONCLUSION Clinical pharmacists should be famil-iar with the characteristics of antithrombotic drugs and antithrombotic treatment strategies under different circum-stances,and assist physicians to formulate individualized treatment plans according to the individual conditions of pa-tients,so as to further improve the effectiveness and safety of clinical drug treatment.
关键词
心房颤动/TAVI/急性缺血性脑卒中/抗栓治疗Key words
Atrial fibrillation/TAVI/Acute ischemic stroke/Antithrombotic therapy引用本文复制引用
出版年
2024
NETL
NSTL
万方数据