临床药师对住院心房纤颤患者抗凝治疗的药学干预分析

发布时间：2019-03-21 16:52

【摘要】：目的回顾性分析比较临床药师药学干预前后心房颤动患者的抗凝现状,为提高抗凝治疗的安全性、合理性提供参考。方法将2014、2015年度该院住院心房颤动患者分别作为对照组(718例)与观察组(825例),其中观察组给予药学干预。对两组患者的抗凝治疗率、抗凝药物相关出血反应、凝血酶原时间(PT)经校正后的国际标准化比值(INR)等情况进行回顾调查与比较。同时对高龄(≥75岁)、合并慢性疾病、卒中风险评分(CHA2DS2-VASc)及出血风险评分(HAS-BLED)等因素进行回归分析。结果干预后观察组抗凝治疗率(19.8%)明显高于对照组(15.0%),差异有统计学意义(P0.05),且抗凝药物相关出血不良反应发生率降至2.76%。干预后观察组INR达标率(22.1%)低于对照组(45.4%),差异有统计学意义(P0.05)。多因素logistic回归分析显示,对照组抗凝治疗影响因素为高龄、CHA2DS2-VASc评分及HAS-BLED评分(R_1=-0.287,R_2=0.095,R_3=-0.030);观察组抗凝治疗影响因素为高龄、有糖尿病史、CHA2DS2-VASc评分(R_1′=-0.279,R_2′=-0.052,R_3′=0.009)。结论药学干预提高了该院心房颤动抗凝治疗率,但总抗凝治疗率仍低于国内平均水平,临床药师需进一步加强用药安全性、合理性、依从性等方面管理。
[Abstract]:Objective to analyze and compare the present situation of anticoagulation in patients with atrial fibrillation before and after pharmaceutical intervention by clinical pharmacists, so as to provide reference for improving the safety and rationality of anticoagulation therapy. Methods the patients with atrial fibrillation in 2014 and 2015 were selected as control group (718 cases) and observation group (825 cases), in which pharmaceutical intervention was given to the observation group. The anticoagulant treatment rate, anticoagulation drug-related bleeding response, and the corrected international standardized ratio (INR) of prothrombin time (PT) were retrospectively investigated and compared between the two groups. At the same time, the age (鈮，

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