消化道肿瘤术后化疗相关性恶心呕吐防治的信息化外科药学实践  

Informatized surgical pharmacy practice for the prevention and treatment of chemotherapy-related nausea and vomiting after gastrointestinal tumor surgery

作　　者：卢钧雄[1] 张建盼 陈晓娜 张实 梁诗雨 王冰娜 王若伦[1] LU Jun-xiong;ZHANG Jian-pan;CHEN Xia-na;ZHANG Shi;LIANG Si-yu;WANG Bing-na;WANG Ruo-lun(Department of Pharmacy,The Second Affiliated Hospital of Guangzhou Medical University,Guangdong Guangzhou 510310,China;Gastrointestinal Surgery,The Second Affiliated Hospital of Guangzhou Medical University,Guangdong Guangzhou 510310,China;Department of Information,The Second Affiliated Hospital of Guangzhou Medical University,Guangdong Guangzhou 510310,China)

机构地区：[1]广州医科大学附属第二医院,药学部,广东广州510310 [2]广州医科大学附属第二医院,胃肠外科,广东广州510310 [3]广州医科大学附属第二医院,信息科,广东广州510310

出　　处：《中国医院药学杂志》2023年第7期795-798,812,共5页Chinese Journal of Hospital Pharmacy

基　　金：广东省医院药学研究基金项目(编号:2020A25);广东省临床用药研究基金(编号:2021ZT17)。

摘　　要：目的:探索化疗相关性恶心呕吐信息化药学平台联合外科药学服务对消化道肿瘤术后化疗患者的作用和效果。方法:外科药师参与化疗相关恶心呕吐信息化药学平台的建设,包括用药信息库和阶梯式用药路径的构建和应用;外科药师对外科医生、护士和患者提供差异化的化疗相关性恶心呕吐药学服务。外科药师在胃肠外科进行临床实践,并收集药学干预前后大肠癌术后化疗患者的病例资料。比较两组化疗患者的恶心呕吐防治效果,进一步优化药学服务,实现药学转型新形式。结果:共入组患者85例,分别为干预前41例和干预后44例,干预后化疗相关急性呕吐和延迟性呕吐的控制有效率均高于干预前,差异有统计学意义(P=0.009和P=0.039);干预后患者的用药依从性高于干预前,差异有统计学意义(P=0.000)。结论:信息化药学平台联合外科药学服务对大肠癌术后患者化疗相关恶心呕吐的防治效果显著,不仅利于外科药师在药学服务转型中积累实践经验,也为医院药学的信息化建设提供了新思路。OBJECTIVE To explore the role and effect of the information-based pharmacy platform combined with surgical pharmacy service for chemotherapy-related nausea and vomiting(CINV)in patients with postoperative chemotherapy for gastrointestinal tumors.METHODS Surgical pharmacists participated in the construction of an information-based pharmacy management platform for CINV,including the construction of a medication information database and a stepped medication route for CINV.Surgical pharmacists provided differentiated CINV services for surgeons,nurses and patients.Surgical pharmacists conducted clinical practice in gastrointestinal surgery and collected the case data of patients undergoing chemotherapy for colorectal cancer before and after pharmaceutical intervention.The prevention and treatment effects of nausea and vomiting were compared between the two groups of chemotherapy patients,pharmaceutical services were further optimized,and new forms of pharmaceutical transformation was explored.RESULTS A total of 85 patients were enrolled,including 41 before intervention and 44 after intervention.The effective rate of chemotherapy-related acute emesis and delayed emesis after intervention was higher than that before intervention(P=0.009&P=0.039).The medication adherence of patients after intervention was higher than that before intervention(P=0.000).CONCLUSION The information-based pharmacy platform combined with surgical pharmacy services has a significant effect on the patients with CINV,and it not only accumulates practical experience for surgical pharmacists in the transformation of pharmacy services,but also provides new ideas for the informatization construction of hospital pharmacy.

关 键 词：外科药师 化疗相关性恶心呕吐 信息化 药学服务 

分 类 号：R730.5[医药卫生—肿瘤]