1例主动脉机械瓣置换术后合并稽留流产患者的药学监护实践 点击下载
| 论文标题： | 1例主动脉机械瓣置换术后合并稽留流产患者的药学监护实践 |
| 英文标题： | |
| 中文摘要： | 目的 为主动脉机械瓣置换术后合并稽留流产患者的抗凝治疗和药物流产期间阴道出血管理提供参考。方法临床药师对1例主动脉机械瓣置换术后合并稽留流产患者开展药学监护，分析华法林使用与流产的相关性。针对患者服用米非司酮后出现牙龈出血、国际标准化比值（INR）升高，临床药师根据出血风险及INR变化等建议停用华法林；针对患者稽留流产后性激素类药物的选择，临床药师建议采用雌二醇凝胶联合黄体酮进行序贯治疗，并辅以鲜益母草胶囊，加快宫腔内残留组织及淤血排出。结果医师采纳临床药师的建议。患者治疗期间未因阴道大量出血而延长住院时间，出院当日重启华法林治疗，出院后INR稳定在目标抗凝范围内且未发生血栓栓塞等不良事件。结论主动脉机械瓣置换术后合并稽留流产患者在药物流产期间，米非司酮可能增强华法林的抗凝作用，增加出血风险，建议在用药前停用华法林。临床药师在抗凝方案制定、药物相互作用识别、出血风险评估及术后性激素选择等环节发挥关键作用，通过全程药学监护，保障了患者的用药安全。 |
| 英文摘要： | OBJECTIVE To provide a reference for anticoagulant therapy and vaginal bleeding management during medical abortion in patients with missed abortion after aortic mechanical valve replacement surgery. METHODS Clinical pharmacists conducted pharmaceutical monitoring on a patient with missed abortion after aortic mechanical valve replacement surgery， and analyzed the correlation between warfarin use and abortion. In response to gingival bleeding and an increase in the international normalized ratio （INR） after taking mifepristone， clinical pharmacists recommended discontinuing warfarin based on bleeding risk and INR changes； for the selection of sex hormones after missed abortion， clinical pharmacists suggested that estradiol gel combined with progesterone should be used in sequential treatment， supplemented by Xian yimucao capsules， to accelerate the elimination of residual tissue and congestion in uterine cavity. RESULTS The physician followed the advice of the clinical pharmacist and did not prolong the patient’s hospital stay due to excessive vaginal bleeding during treatment. Warfarin treatment was restarted on the day of discharge， and INR remained stable within the target anticoagulation range after discharge without any adverse events such as thromboembolism. CONCLUSIONS In patients with missed abortion after aortic valve replacement surgery， mifepristone may enhance the anticoagulant effect of warfarin and increase the risk of bleeding during medical abortion. It is recommended to discontinue warfarin before medication. Clinical pharmacists play a crucial role in the development of anticoagulation plans， identification of drug-drug interactions， assessment of bleeding risks， and selection of postoperative sex hormones. Through full pharmaceutical monitoring， they ensure the safety of patients’ medication. |
| 期刊： | 2026年第37卷第13期 |
| 作者： | 陈欢；王柏桉；杜青青；穆瑶 |
| 英文作者： | CHEN Huan，WANG Baian，DU Qingqing，MU Yao |
| 关键字： | 主动脉机械瓣置换术; 稽留流产; 抗凝治疗; 药物流产; 药物相互作用 |
| KEYWORDS： | aortic mechanical valve replacement surgery; missed abortion; anticoagulant therapy; medical abortion; drug-drug interactions |
| 总下载数： | 81次 |
| 本日下载数： | 2次 |
| 本月下载数： | 81次 |
| 文件大小： | 619.60Kb |
* 注：未经本站明确许可，任何网站不得非法盗链资源下载连接及抄袭本站原创内容资源!在此感谢您的支持与合作！