某院药学门诊310例患者使用华法林的随访分析  

Follow-up analysis of 310 patients taking warfarin in the pharmacy clinic of a hospital

作　　者：程小荣[1] 廖础欣[1] 刘锐锋[1] 卢荣枝[1] 王桂凤[1] CHENG Xiao-rong;LIAO Chu-xin;LIU Rui-feng(Dept.of Pharmacy,Zhongshan Municipal People’s Hospital,Zhongshan 528403,China)

机构地区：[1]中山市人民医院药学部,广东中山528403

出　　处：《中国处方药》2022年第5期40-42,共3页Journal of China Prescription Drug

基　　金：中山市科技局项目(2019B1080,2018B1059)。

摘　　要：目的研究某院药学门诊对服用华法林患者的随访管理工作,保障华法林的用药安全性和有效性。方法收集某院药学门诊2017年1月~2021年1月310例使用华法林治疗患者的随访资料进行统计分析。结果230例(74.19%)不了解华法林的药理作用、不良反应、影响因素及用药注意事项等,45例(14.52%)部分知道华法林药理作用、不良反应,35例(11.29%)对各项评价指标有较全面的了解。106例(34.19%)患者出现出血现象。159例(51.29%)患者不了解华法林有出血等不良反应。310例随访患者中178例(57.42%)能定期服用华法林,并能定期监测INR。104例(33.54%)患者不定期监测INR,28例(9.03%)患者依从性差,对华法林治疗不够重视,自动停药,不定期监测INR指标和漏服药物。INR监测情况:INR值2.0~3.0,有102例,占32.91%;INR<2.0,141例,占45.48%;INR>3.0~5.0,39例,占12.58%,INR>5.0,28例,占9.03%。结论为进一步保障服用华法林用药安全性和有效性,结合患者服药过程中存在的问题,有必要在医院药学门诊开展抗凝管理,对预防和治疗血栓栓塞性疾病以及提高抗凝药物使用的规范性有重要意义。Objective To study the follow-up management of patients taking warfarin in the pharmacy clinic of a hospital.Methods The follow-up data of 310 warfarin-treated patients from January 2017 to January 2021 in a pharmacy clinic of a hospital were collected for statistical analysis.Results 230 cases(74.19%)did not understand the evaluation indicators of warfarin's pharmacological effects,adverse reactions,influencing factors and precautions for medication,45 cases(14.52%)partially knew the pharmacological effects and adverse reactions of warfarin,35 cases(11.29%)have a comprehensive understanding of various evaluation indicators.106 patients(34.19%)had bleeding.159 patients(51.29%)were not aware that warfarin had side effects such as bleeding.Among the 310 follow-up patients,178(57.42%)were able to take warfarin regularly and monitor the INR regularly.104 patients(33.54%)were monitored irregularly for INR,28 patients(9.03%)had poor compliance,did not pay enough attention to warfarin treatment,automatically stopped the drug,monitored INR indicators irregularly and missed medication.And the patients INR monitoring wereasfollows:102 cases(32.91%)kept the INR value 2.0~3.0;INR<2.0,141 cases(45.48%);INR>3.0~5.0,39 cases,(12.58%),INR>5.0,28 cases(9.03%).Conclusion In order to further ensure the safety and effectiveness of warfarin medication,it is necessary to carry out anticoagulation management in the hospital pharmacy outpatient department in combination with the problems existing in the patient's medication process.This is of great significance to the prevention and treatment of thromboembolic diseases and to regulate the use of anticoagulant drugs.

关 键 词：药学门诊 华法林 抗凝治疗 用药依从性 药师干预 

分 类 号：R969[医药卫生—药理学]