血栓弹力图指导支架内血栓后不稳定心绞痛治疗1 例及文献复习

目的:探讨在血栓弹力图监测血小板抑制率的情况下,调整氯吡格雷及阿司匹林用量,治疗冠心病、PCI术后支架内再发血栓患者的临床意义。方法:报告中国人民解放军总医院1例支架内亚急性血栓患者的临床资料并复习相关文献,对其临床表现、诊断、在血栓弹力图指导下的治疗进行分析。结果:1例支架内亚急性血栓患者经治疗病情好转出院,出院后继续调整氯吡格雷及阿司匹林用量,达到满意血小板抑制率,患者症状消失。结论:冠状动脉介入治疗后发生支架内血栓的患者,应用血栓弹力图指导氯吡格雷及阿司匹林用量,可达到令人满意的血小板抑制率,并防止出血情况发生。

The Treatment under the Guidance of Thromboelastography of One CaseReport about Stent Thrombosis after Percutaneous Coronary Interventionwith Discussion On the Application of Thromboelastography

Objective: To discuss the clinical significance of adjusting amount of clopidogrel and aspirin under the guidance of throm-boelastography on the patients with the sub-acute stent thrombosis after the percutaneous coronary intervention.Methods: Report one case of acute stent thrombosis in the General Hospital of People’s Liberation Army,discuss the clinical data and clinical manifestations,analyze the treatment under the guidance of thromboelastography.Results: 1 case of sub-acute stent thrombosis was turned better and discharged from hos-pital after treatment,and continued to have adjusted amount of clopidogrel and aspirin under the guidance of thromboelastography,in order to achieve satisfactory platelet inhibition,until symptoms disappeared.Conclusion: The patients with sub-acute stent thrombosis after percuta-neous coronary intervention can achieve satisfactory inhibition rate of platelets and prevent from bleeding by adjusting amount of clopidogrel and aspirin under the guidance of thromboelastography.