基于肾功能水平的老年骨折患者药物治疗管理分析  

Analysis of medication management in elderly patients based on renal function

作　　者：武丹威[1] 杨明辉[2] 王起 毛璐[1] 甄健存[1] WU Dan-wei;YANG Ming-hui;WANG Qi;MAO Lu;ZHEN Jian-cun(Department of Pharmacy,Beijing Jishuitan Hospital,Beijing 100035,China;Department of Orthopedics,Beijing Jishuitan Hospital,Beijing 100035,China;Department of Health,Liqiao Town,Shunyi District,Beijing 101304,China)

机构地区：[1]北京积水潭医院药学部,北京100035 [2]北京积水潭医院创伤骨科,北京100035 [3]北京市顺义区李桥镇卫生院,北京101304

出　　处：《临床药物治疗杂志》2022年第3期64-67,共4页Clinical Medication Journal

基　　金：北京市医院管理中心消化协同项目:骨科患者围手术期应激性溃疡预防用药有效性和安全性随机对照研究(XXZ0605)。

摘　　要：目的分析基于肾功能水平的老年髋部骨折患者药物治疗管理。方法纳入2018年9月至2021年3月因髋部骨折入住老年创伤科65岁以上患者。临床药师基于患者肾功能水平向医师提出围手术期用药方案建议。结果共纳入患者1508人,平均年龄(79.56±7.84)岁,体质量(59.57±12.26)kg,Ccr<30 mL/(min·1.73m^(2))患者有97例,占6.49%。将患者按年龄分组,血肌酐水平差异有统计学意义(F=10.30,P=0.00),但血肌酐水平仍在正常范围;Ccr水平差异有统计学意义(F=234.99,P=0.00)。以体质量进行分组,各组患者血肌酐水平差异无统计学意义(F=2.38,P=0.22),而Ccr水平差异有统计学意义(F=112.40,P=0.00)。药师根据患者Ccr进行围手术期抗感染药物及抗凝药物方案调整建议合计119次,医师采纳率87.39%。结论基于肾功能水平的药物治疗管理在一定程度上避免了用药风险,保证了用药安全。Objective To analyze the management of combined drug therapy for elderly patients with hip fracture based on renal function.Methods Elderly patients over 65 years old who were admitted to the geriatric trauma department for hip fracture from September 2018 to March 2021 were enrolled.Clinical pharmacists provided a reference of perioperative medication regimen based on patients’renal function.Results A total of 1508 elderly patients were admitted with an average age of(79.56±7.84)years old,body weight of(59.57±12.26)kg,and Ccr<30 mL/(min·1.73m^(2))in 97 patients,accounting for 6.49%.The patients were grouped by age The serum creatinine levels were statistically significant among different groups(F=10.30,P=0.00),while the serum creatinine levels of all groups were normal.There was significant difference in Ccr level among all groups(F=234.99,P=0.00).In the term of body weight,there was no significant difference in serum creatinine level among all groups(F=2.38,P=0.22),while Ccr level was statistically significant(F=112.40,P=0.00).Pharmacists adjusted perioperative antiinfective drugs and anticoagulant drugs according to Ccr 119 times in total,and the pharmacist adoption rate was 87.39%.Conclusion Drug therapy management based on renal function avoids medication risk and ensure medication safety to a certain extent.

关 键 词：老年 髋部骨折 肾功能不全 内生肌酐清除率 药物治疗管理 

分 类 号：R979.9[医药卫生—药品] R683.6[医药卫生—药学]