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利伐沙班治疗儿童肿瘤相关性血栓1例报告
作者:魏萌1  徐婷婷1 2  张晏洁1  齐谢敏1  黄晓晖1 
单位:1. 东部战区总医院 临床药学科, 江苏 南京 210002;
2. 东部战区总医院淮安医疗区 药剂科, 江苏 淮安 223001
关键词:利伐沙班 肿瘤相关性血栓 儿童 
分类号:R738.1;R973.2
出版年·卷·期(页码):2020·39·第三期(266-269)
摘要:

目的:验证利伐沙班用于儿童肿瘤相关性血栓抗凝治疗的安全性与有效性。方法:临床药师全程参与1例7岁骨肉瘤患儿中心静脉导管相关性血栓的抗凝治疗药学监护,为其制定个体化的利伐沙班(5 mg,bid)抗凝方案,并通过抗凝门诊监测凝血酶原时间(PT)指标和利伐沙班谷质量浓度,随访抗凝的安全性和有效性。结果:利伐沙班抗凝1个月后患儿左上肢血栓消失,期间监测PT平均值为(12.33±0.88)s,利伐沙班谷质量浓度平均值为(24.67±7.42)ng·ml-1,均在参考范围内,未出现新发血栓或出血症状。结论:利伐沙班可作为肿瘤相关血栓患儿口服抗凝治疗的一种选择,联合监测血药质量浓度和PT可在一定程度上保证这一特殊人群用药的安全性及有效性。

Objective:To verify the safety and effectiveness of rivaroxaban treating tumor-associated thrombus in children. Methods:A 7-year-old child with osteosarcoma underwent left upper extremity thrombus induced by PICC. Clinical pharmacist established the anticoagulant therapy of rivaroxaban (5 mg, bid) for him. Prothrombin time(PT) and trough concentration of rivaroxaban were monitored. The safety and effectiveness of rivaroxaban were evaluated during through the anticoagulation treatment and 1 month after his discharge. Results:The thrombus was disappeared, no new thrombus or hemorrhage was found. The mean value of PT was (12.33±0.88)s, and the mean value of the trough concentration of rivaroxaban was (24.67±7.42)ng·ml-1, all of them were within the reference range. Conclusion:Rivaroxaban may be an option for oral anticoagulant therapy in children with tumor-associated thrombosis. Combined monitoring of blood drug concentration and prothrombin time can ensure the safety and effectiveness of drug use in this particular population to some extent.

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