华法林抗凝患者的抗凝现状调查及分析  

Investigation and analysis on the current situation of warfarin usage in patients receiving anticoagulant therapy

作　　者：张喆[1] 罗梦林[1] 田敏[2] 张艺[2] 刘全义[3,4] 

机构地区：[1]第三军医大学新桥医院药学部,重庆400037 [2]第三军医大学新桥医院心内科,重庆400037 [3]第三军医大学新桥医院 [4]重庆医科大学药学院药理教研室,重庆400016

出　　处：《中国医院药学杂志》2014年第2期127-130,共4页Chinese Journal of Hospital Pharmacy

摘　　要：目的:了解华法林抗凝患者的抗凝现状,探讨华法林抗凝治疗管理工作的要点。方法:采用合理用药监测系统监测、自制问卷、电话随访相结合的方式,调查某院2012年1-12月600名华法林抗凝患者在住院期间及院外的抗凝现状,并对调查结果进行统计、分析,进而提出抗凝治疗管理工作的要点。结果:华法林抗凝患者平均年龄(58.6±11.9)岁,主要病因为人工瓣膜置换术后和非瓣膜性房颤。患者平均联合用药(4.9±1.9)种,79.2%同时口服4种及以上药物,51.39%联合服用中成药。接受用药教育前,仅6.2%的患者了解服用华法林需要监测凝血指标,9.7%了解药物与华法林会发生相互作用,12.5%了解华法林所致出血的应对措施。患者在院外接受抗凝治疗时,抗凝强度达标率仅21.16%。结论:华法林抗凝患者联合用药比例大、品种多,对抗凝治疗知识的认知度差,院外抗凝治疗达标率低,应开展系统的抗凝治疗管理工作以提高华法林抗凝治疗的安全性和有效性。OBJECTIVE To evaluate the usage of warfarin in anticoagulant patients and to explore the key points of anticoag ulant management service. METHODS A survey of the usage of warfarin for both in-patients and out-patients was conducted from January to December 2012 using PASS system, questionnaires, and telephone interview, further to propose the key points of anticoagulant management service. RESULTS The average age of patients was 58 ＋ 11.9,and the main reason taking warfa rin was artificial valve replacement and atrial fibrillation. These patients took an average of 4. 9 medications, with 79. 20/oo of them taking at least 4 medications, and 51.39~ taking Chinese herb. Awareness rates of coagulation index monitoring, drug in teraction of warfarin, and management of bleeding caused by warfarin was 6. 2 ~/00,9. 7 ~ and 12. 5 ~, respectively. The success rate of anticoagulant therapy was 21. I6~ in outpatients. CONCLUSION Patients taking warfarin often took several other drugs in combination. Patients had poor knowledge of the key points of anticoagulant therapy, and low success rate in outpa tient. Systematic anticoagulant management was needed to improve the safety and efficacy of anticoagulant therapy.

关 键 词：华法林 抗凝治疗管理 药学服务 

分 类 号：R973.2[医药卫生—药品]