抗凝门诊临床药师管理的抗凝效果评价
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篇名: 抗凝门诊临床药师管理的抗凝效果评价
TITLE: Evaluation of Anticoagulant Effects of Clinical Pharmacist Management in Anticoagulation Clinic
摘要: 目的:评价抗凝门诊临床药师管理的抗凝效果。方法:回顾性分析2019年8月-2020年1月南京鼓楼医院(以下简称“我院”)抗凝门诊就诊的481例患者的病历资料,记录其基本信息(性别、年龄、患者分级)、使用的抗凝药物、抗凝原因、抗凝相关检查结果[凝血酶原时间、国际标准化比值(INR)等]、华法林剂量、新型口服抗凝药物(NOACs)使用情况及不良反应发生情况等。结果:481例患者于我院抗凝门诊就诊共1587例次。患者分级分别为一级401例次、二级547例次、三级639例次。470例患者服用华法林,11例服用NOACs(包括6例利伐沙班、5例达比加群酯)。瓣膜置换术为抗凝的主要原因(65.28%),其次为心房颤动(14.97%)、瓣环修复术(12.47%)。凝血酶原时间检测方法以即时检测设备检测为主(83.44%)。三级患者华法林日平均剂量为(3.03±1.28)mg。使用华法林患者的平均INR为1.99±0.56,INR在目标范围内的时间百分比(TTR)为72.79%,其中一级患者平均INR为2.12±0.84、TTR为44.33%,二级患者平均INR为1.95±0.52、TTR为72.34%,三级患者平均INR为1.94±0.33、TTR为90.42%。患者发生小出血102例次(6.43%),发生临床相关非大出血2例次(0.13%),未见大出血和血栓栓塞事件发生。结论:我院抗凝门诊临床药师通过实行分级管理,为患者制定科学的管理措施并进行个体化问诊;患者不良反应症状较轻且发生率较低,服用华法林患者的TTR较高,临床药师管理的抗凝效果明显。
ABSTRACT: OBJECTIVE:To eva luate the anticoagulant effect of clinical pharmacist management in clinic. METHODS :Retro- spective analysis was performed on medical records of 481 patients in anticoagulant clinic of Nanjing Drum Tower Hospital (herein- after referred as “our hospital ”)from Aug. 2019 to Jan. 2020. The general information (gender,age,patient grading )of patients , anticoagulant drug ,anticoagulant causes ,anticoagulant examination [prothrombin time ,international standardized ratio results (INR)],warfarin dose ,NOACs usage and ADR were recorded. RESULTS :Totally 481 patients visited anticoagulant clinic of our hospital for 1 587 times in total. The case number of primary ,secondary and tertiary patients were 401,547 and 639,respectively. 470 patients received warfarin ,and 11 patients received NOACs (including 6 cases of riva roxaban,5 cases of dabigatran etexi - . The valve replacement was the main cause of anticoagu - lation(65.28%),followed by atrial fibrillation (14.97%), valve ring repairment (12.47%). The main detection method NDYG2017012) of prothrombin time was POCT (83.44%). Their average dose of warfarin was (3.03±1.28)mg. The average INR of outpa - tients receiving warfarin was 1.99±0.56,and time within treat - E-mail:xiaochongzi78@sina.com ment range (TTR)was 72.79%. The average INR of the first grade was 2.12±0.84 and the TTR was 44.33%;the average INR of the second grade was 1.95±0.52 and the TTR was 72.34%; the average INR of the third grade was 1.94±0.33 and the TTR was 90.42%. There were 102 cases(6.43%)of small bleeding , and 2 cases(0.13%)of clinical related non major bleeding ;no major bleeding and thromboembolism was observed. CONCLU - SIONS:Clinical pharmacists of anticoagulant clinic in our hospital formulate scientific management and provide individualized con - sultation for patients through implementing hierarchical management of patients. Patients show mild symptoms and low incidence of adverse reactions ;the patients taking warfarin have higher TTR ;clinical pharmacist management has significant anticoagulant effect.
期刊: 2020年第31卷第18期
作者: 李舒悦,回翔,金远香,王娟,张欢,王宝彦,徐航
AUTHORS: LI Shuyue,HUI Xiang,JIN Yuanxiang,WANG Juan,ZHANG Huan,WANG Baoyan,XU Hang
关键字: 抗凝门诊;临床药师;抗凝效果;分级管理;华法林;新型口服抗凝药
KEYWORDS: Anticoagulation clinic ;Clinical pharmacist ;Anticoagulants;Grading management ;Warfarin;NOACs
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