| 赵冰封,黄学桂,陈红波.头孢孟多致凝血功能异常 1例[J].安徽医药,2020,24(10):2087-2090. |
| 头孢孟多致凝血功能异常 1例 |
| Pharmacological analysis of a patient with cefamandole?induced coagulopathy |
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| DOI：10.3969/j.issn.1009?6469.2020.10.043 |
| 中文关键词: 头孢孟多/副作用 血液凝固 N?甲基硫代四氮唑 凝血功能异常 |
| 英文关键词: Cefamandole/adverse effects Blood coagulation N?methylthiotetrazole(NMTT) Abnormal coagulation |
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| 中文摘要: |
| 目的分析头孢孟多导致凝血功能异常的机制，促进临床用药安全。方法本研究报告1例使用头孢孟多［一种含有 N?甲基硫代四氮唑(NMTT)侧链的头孢菌素］后出现凝血功能异常的病例，病人 2019年 3月 24日入院， 2019年 3月 25日行子宫下段剖宫产术，因急性绒毛膜羊膜炎应用头孢孟多酯钠抗感染治疗后检测凝血功能指标异常，予 VitK1肌肉注射治疗， 2019年 3月 31日基本情况良好予出院。通过对凝血功能异常原因分析并行文献循证，探讨其发生机制与防治措施。结果根据病人凝血功能异常发生的时机与处理情况，结合说明书和文献循证结果判断，病人凝血功能异常与使用头孢孟多酯钠有关。具有 NMTT侧链的头孢菌素引起凝血功能异常或出血的风险较高，与其抑制维生素 K(VitK)环氧化物还原酶活性，消耗 VitK依赖性凝血因子有关，其作用机制与华法林类似。结论医护人员及临床药师要充分注意该类药物引起不良反应，采取积极的预防与干预措施。 |
| 英文摘要: |
| Objective To analyze the mechanism of cefamandole induced abnormal blood coagulation and promote the safety of clinical medication.Methods This article reported a case of coagulation abnormality after the use of cefamandole［a cephalosporin containing N?methylthiotetrazolium(NMTT)side chain］.The patient was admitted to the hospital on March 24，2019.Lower uterine cesarean section was performed on March 25，2019.Abnormal blood clotting function was detected after anti?infective treatment withcefamandole sodium for acute chorioamnionitis，and VitK1 intramuscular injection was given.The patient was discharged from hospi? tal in well condition on March 31，2019.Through literature?based evidence and causes analysis of abnormal coagulation function，the mechanism and prevention measures are discussed.Results According to the timing of the abnormal coagulation function，the pa? tient′s condition improved after treatment，the instructions and the evidence?based results of the literature judged that the abnormalcoagulation function was related to the use of cefamandole sodium.Cephalosporins with NMTT side chains had higher risk of caus?ing abnormal blood coagulation or bleeding，mainly caused by the depletion of vitamin K?dependent clotting factors via inhibition of the vitamin K epoxide reductase，and the mechanism of action was similar as warfarin.Conclusion Medical staff and clinical phar? macists should pay full attention to the adverse reactions caused by this type of antibiotics，and take active prevention and interven? tion measures. |
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