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[使用直接口服抗凝剂(阿哌沙班)单药治疗溃疡性结肠炎患者的导管血栓形成和肺血栓栓塞:一例报告]

[Monotherapy using a direct oral anticoagulant (apixaban) for catheter thrombosis and pulmonary thromboembolism in a patient with ulcerative colitis: a case report].

作者信息

Yamazaki Takeaki, Hosaka Ryosuke, Torii Yukimitsu, Nishiyama Satoshi, Mihara Mika, Matsunaga Shinsuke, Satomi Satoko, Dojo Manabu, Yamazaki Yukinao

机构信息

Department of Gastroenterology, Fukui Red Cross Hospital.

出版信息

Nihon Shokakibyo Gakkai Zasshi. 2020;117(11):992-1000. doi: 10.11405/nisshoshi.117.992.

Abstract

A 20-year-old woman with ulcerative colitis flare was admitted to Fukui Red Cross Hospital. During treatment with granulocyte and monocyte apheresis (GMA), the patient complained of chest discomfort and was diagnosed with pulmonary thromboembolism with central intravenous catheter thrombosis. Apixaban, a direct oral anticoagulant (DOAC), was used as monotherapy for anticoagulation, and thromboembolism was resolved without complication. Among extraintestinal complications in patients with ulcerative colitis, pulmonary thromboembolism can be a life-threatening condition and requires prompt anticoagulant therapy. Although the effectiveness of conventional pharmacological anticoagulation using warfarin and heparin has been reported, the efficacy of DOAC monotherapy remains controversial. DOAC monotherapy may be considered and innovative therapeutic strategy for a thromboembolic condition in patients with ulcerative colitis.

摘要

一名患有溃疡性结肠炎发作的20岁女性入住福井红十字医院。在进行粒细胞和单核细胞分离术(GMA)治疗期间,患者主诉胸部不适,被诊断为伴有中心静脉导管血栓形成的肺血栓栓塞症。阿哌沙班,一种直接口服抗凝剂(DOAC),被用作抗凝单一疗法,血栓栓塞症得到解决且无并发症。在溃疡性结肠炎患者的肠外并发症中,肺血栓栓塞症可能是危及生命的病症,需要及时进行抗凝治疗。虽然已经报道了使用华法林和肝素进行传统药物抗凝的有效性,但DOAC单一疗法的疗效仍存在争议。DOAC单一疗法可能被视为溃疡性结肠炎患者血栓栓塞病症的一种创新治疗策略。

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