1例PCI术后盐酸替罗非班诱导的极重度血小板减少的护理

目的 探讨冠状动脉介入术后患者盐酸替罗非班诱发的极重度血小板减少症的临床特点及护理情况，为替罗非班诱导的血小板减少症患者护理提供临床参考。方法 2017年11月我院收治1例急性冠状动脉综合征患者，PCI术后应用盐酸替罗非班致极重度GIT的临床资料及护理情况进行报告。结果 患者PCI术前血小板计数正常，术后应用盐酸替罗非班6 h后出现全身多处瘀斑，血小板计数严重下降至0×109/L，立即停用替罗非班、阿司匹林、氯吡咯雷，并输注血小板、冷冻血浆及使用糖皮质激素治疗，做好防出血护理、用药护理、生活护理、心理干预，血小板计数逐渐升高，约84 h恢复正常。结论 PCI患者应用盐酸替罗非班有诱导的GIT发生风险，积极监测患者血小板变化，加强防出血护理及心理干预，能促进病情恢复。

Nursing Care of a Case of Extremely Severe Thrombocytopenia Induced by Tirofiban Hydrochloride after PCI

Abstract:Objective To explore the clinical characteristics and nursing of tirofiban hydrochloride induced thrombocytopenia in patients after coronary intervention,and to provide clinical reference for the nursing of tirofiban hydrochloride induced thrombocytopenia.Methods 1 patient with acute coronary syndrome were treated in our hospital in November 2017.The clinical data and nursing care of patients with severe GIT after tirofiban hydrochloride after PCI were reported.Results The platelet count was normal before PCI.After 6 h of administration of tirofiban hydrochloride,there were many ecchymosis in the whole body.The platelet count decreased to 0×109/L.Immediately discontinue tirofiban,aspirin,clopidogrel,and infusion of platelets,frozen plasma and treatment with glucocorticoids,anti-bleeding care,medication care,life care,psychological intervention,platelet count gradually increased,about 84 h returned to normal.Conclusion PCI patients with tirofiban hydrochloride induced risk of GIT,actively monitor patients with platelet changes,strengthen anti-bleeding care and psychological intervention,can promote the recovery of the disease.