WONCA研究论文摘要汇编——德国全科医疗抗凝治疗的整群随机对照试验筛查

发布时间：2019-06-19 07:31

【摘要】：目的口服抗凝药物(OAC)联合应用香豆素、新抗凝剂治疗血栓栓塞并发症的效果非常显著。然而,有研究表明,治疗中经常会出现抗凝剂使用过量或用量不足。本文探讨长期服用OAC患者的正确治疗方法,并根据整群随机PICANT试验的筛查结果,对此类患者的相关特点进行总结。方法在德国黑森州随机选取全科诊所,由研究成员进行到访研究。使用全科医生软件,以预先设定指令生成匿名患者名单,以该匿名名单对符合条件的患者进行调查。符合条件的患者被分为3组,A组为具有长期使用OAC指征且正服用抗凝剂的患者;B组为具有长期使用OAC指征但未服用抗凝剂的患者;C组为不具有长期服用OAC指征但长期服用抗凝剂的患者。采用SPSS 20.0软件进行描述性统计分析。结果 52家全科诊所纳入2 036例符合条件的患者,其中,275例患者因无法归类而被排除。最终纳入研究的患者1 761例,其中,A组1 641例,B组78例,C组42例。获取1 504例患者的国际标准化比值(INR),其中1 013例患者的INR处在治疗区间。全科医生软件评估发现,大部分患者具有良好的治疗依从性,6.1%的患者服用了新型抗凝剂。结论大部分患者的抗凝疗法正确,应长期使用OAC但未服用抗凝剂的患者和不应长期使用OAC但长期服用抗凝剂的患者低于预期,OAC的控制效果在合理高值范围内。
[Abstract]:Objective to treat the complications of thrombus embolism with oral anticoagulant (OAC) combined with coumarin. However, studies have shown that anticoagulant is often overused or insufficient in treatment. In this paper, the correct treatment of patients taking OAC for a long time was discussed, and the related characteristics of these patients were summarized according to the screening results of cluster random PICANT test. Methods the general clinic was randomly selected in Hesse, Germany, and the research members were visited. Use the general practitioner software to generate a list of anonymous patients with predetermined instructions, and use the anonymous list to investigate eligible patients. The eligible patients were divided into three groups: group A (patients with long-term use of OAC indication and taking anticoagulant), group B (patients with long-term use of OAC indication but not anticoagulant) and group C (patients who did not have long-term OAC indication but took anticoagulant for a long time). Descriptive statistical analysis was carried out with SPSS 20.0 software. Results 2036 eligible patients were included in 52 general practice clinics, of which 275 patients were excluded because they could not be classified. Finally, 1761 cases were included in the study, including 1641 cases in group A, 78 cases in group B and 42 cases in group C. The international standardized ratio (INR),) of 1 504 patients was obtained. The INR of 1 013 patients was in the treatment range. General practitioners software evaluation found that most patients had good treatment compliance, 6.1% of patients took new anticoagulant. Conclusion the anticoagulant therapy of most patients is correct. The patients who should use OAC for a long time but not take anticoagulant for a long time and those who should not use OAC for a long time but take anticoagulant for a long time are lower than expected. The control effect of OAC is within a reasonable and high range.
【分类号】：R96

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