新型冠状病毒肺炎相关静脉血栓防治的药学服务

目的:介绍新型冠状病毒肺炎(COVID-19)治疗期间,静脉血栓(VTE)防治的药学监护策略。方法:通过查阅不同人群(如儿童、孕妇、老年患者)VTE防治的文献和指南,结合临床药师实践工作经验和对应的药品相关信息,给出不同COVID-19患者人群防治VTE的监护要点和用药参考。结果:对于所有确诊的COVID-19住院患者均应进行VTE风险评估,并根据评估结果采取预防措施。对于儿童COVID-19患者,药物预防VTE可选择达肝素钠和依诺肝素钠;对于妊娠和哺乳期COVID-19患者,建议首选低分子肝素(LMWH);对于肝肾功能不全患者,应根据肝肾功能状态评估,进行药物选择和剂量调整。结论:COVID-19患者并发VTE是临床较为严重的情况之一,严重影响患者的治疗和预后,因此进行及时的VTE风险评估和防治,并提供实时的药学监护服务是十分必要的。

Pharmaceutical services for prevention and treatment of venous thrombosis associated with the corona virus disease 2019(COVID-19)

OBJECTIVE To introduce the pharmaceutical care strategy for the prevention and treatment of venous thrombosis(VTE)during the treatment of corona virus disease 2019(COVID-19).METHODS By referring to the literature and guidelines on the prevention and treatment of VTE in different populations(such as children,pregnant women and elderly patients),combined with the practical work experience of clinical pharmacists and relevant drug information,the monitoring points and medication references of the prevention and treatment of VTE in different populations of COVID-19 patients were demonstrated.RESULTS VTE risk assessment should be performed for all diagnosed COVID-19 inpatients and preventive measures should be taken accordingly.For children with COVID-19,dheparin sodium and enoxaparin sodium can be selected for VTE prophylaxis.Low molecular weight heparin(LMWH)is preferred for COVID-19 patients during pregnancy and lactation.For patients with hepatic and renal insufficiency,drug selection and dose adjustment should be carried out according to the evaluation of hepatic and renal function status.CONCLUSION VTE in COVID-19 patients is one of the serious clinical conditions,which seriously affects the treatment and prognosis of patients.Therefore,it is necessary to conduct timely risk assessment,prevention and treatment of VTE,and provide real-time pharmaceutical care.