利伐沙班致严重胃肠道出血死亡病例分析
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摘要
目的分析临床在使用利伐沙班过程中应注意监测的严重出血风险,提高临床使用的安全性。方法通过对1例使用利伐沙班后出现严重胃肠道出血并死亡的案例报道,结合国内外相关文献报道进行分析。结果和结论临床在使用利伐沙班抗凝治疗的时候,首先应严格遵从说明书用药,尽量避免超说明书用药;其次,对于本身具有较高出血风险的患者,在用药前必须权衡血栓栓塞事件与出血的风险;在用药过程中密切随访,及时发现异常并干预,务必做好患者及其监护人的用药教育,密切观察的出血不良反应情况,以免错过最佳干预时机。
Objective To analyze the severe bleeding risk of clinical application for rivaroxaban,and to improve the safe use of rivaroxaban.Methods Through the report of a gastrointestinal bleeding death case caused by rivaroxaban and combining the related literatures reported at home and abroad for analysis. Results & Conclusion Firstly,before using rivaroxaban,medical staff and patient should obey the package insert of rivaroxaban. Secondly, for patients who have high risk of bleeding,should weigh the benefit and risk before using rivaroxaban.Medical staff should teach patient or their caregivers to notice the sign of bleeding and detected blood routine at regular intervals,in order not to miss the best treating opportunity.
Objective To analyze the severe bleeding risk of clinical application for rivaroxaban,and to improve the safe use of rivaroxaban.Methods Through the report of a gastrointestinal bleeding death case caused by rivaroxaban and combining the related literatures reported at home and abroad for analysis. Results & Conclusion Firstly,before using rivaroxaban,medical staff and patient should obey the package insert of rivaroxaban. Secondly, for patients who have high risk of bleeding,should weigh the benefit and risk before using rivaroxaban.Medical staff should teach patient or their caregivers to notice the sign of bleeding and detected blood routine at regular intervals,in order not to miss the best treating opportunity.
引文
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[2]MANN K G,BUTENAS S,BRUMMEL K.The dynamics of thrombin formation[J].Arterioscler Thromb Vasc Biol,2003,23(1):17-25.
[3]RAUCH U,NEMERSON Y.Circulating tissue factor and thrombosis[J].Curr Opin Hematol,2000,7(5):273-277.
[2]MANN K G,BUTENAS S,BRUMMEL K.The dynamics of thrombin formation[J].Arterioscler Thromb Vasc Biol,2003,23(1):17-25.
[3]RAUCH U,NEMERSON Y.Circulating tissue factor and thrombosis[J].Curr Opin Hematol,2000,7(5):273-277.