药品质量控制视域下在深静脉血栓中预防性应用不同抗凝血药的合理性分析  

Rationality Analysis of Preventive Use of Different Anticoagulants in Deep Vein Thrombosis from the Perspective of Drug Quality Control

作　　者：马亮英[1] 蒋磊[2] 侯彦杰[3] MA Liangying;JIANG Lei;HOU Yanjie(Dept.of Pharmacy,the Second Affiliated Hospital of Xinjiang Medical University,Urumqi 830028,China;Dept.of Pharmacy,the Affiliated Cancer Hospital of Xinjiang Medical University,Urumqi 830000,China;Dept.of Orthopedics,the Second Affiliated Hospital of Xinjiang Medical University,Urumqi 830028,China)

机构地区：[1]新疆医科大学第二附属医院药学部,乌鲁木齐830028 [2]新疆医科大学附属肿瘤医院药学部,乌鲁木齐830000 [3]新疆医科大学第二附属医院骨科,乌鲁木齐830028

出　　处：《中国医院用药评价与分析》2023年第8期1004-1007,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：新疆维吾尔自治区自然科学基金资助项目(No.2019D01C236)。

摘　　要：目的:探析药品质量控制视域下在深静脉血栓(DVT)中预防性应用低分子肝素、华法林、阿司匹林3种不同类型抗凝血药的合理性。方法:采用回顾性分析方法,随机抽样选择2021年新疆医科大学第二附属医院300例骨科手术患者作为研究对象。基于医院信息系统,收集患者性别、年龄、手术类型、处方开具情况等相关信息,记录抗凝血药使用情况,分析不同特征患者预防用药情况,比较各类抗凝血药预防DVT的情况,并评估抗凝血药的使用合理性。结果:300例骨科手术患者中,287例预防性使用抗凝血药,预防性使用率为95.67%。287例预防性使用抗凝血药的患者中,单纯使用低分子肝素125例(占43.55%),低分子肝素与华法林联合应用65例(占22.65%),低分子肝素与阿司匹林联合应用34例(占11.85%),单纯使用华法林34例(占11.85%),单纯使用阿司匹林29例(占10.10%);男性、女性患者分别为156例(占54.36%)、131例(占45.64%);≤40、>40~60、>60~75和>75岁患者分别为35例(占12.20%)、103例(占35.89%)、139例(占48.43%)和10例(占3.48%);全髋关节置换术、全膝关节置换术和髋部骨折手术患者分别为209例(占72.82%)、29例(占10.10%)和49例(占17.07%)。单纯使用华法林、单纯使用低分子肝素预防DVT的效果优于单纯使用阿司匹林,但差异无统计学意义(P>0.05);而低分子肝素与华法林联合应用、低分子肝素与阿司匹林联合应用预防DVT的效果远高于单纯使用阿司匹林,差异有统计学意义(P<0.05)。低分子肝素、华法林、阿司匹林的不合理使用率比较,差异有统计学意义(P<0.05);其中低分子肝素、华法林的不合理使用率低于阿司匹林,阿司匹林存在显著不合理用药情况。不合理用药主要涉及品种选择、给药方案和会诊权限不合理,其中具体原因主要为特殊人群用药错误、用法与用量错误、配伍用药错误、用药疗程错误、特殊会诊记录及病程记�OBJECTIVE:To probe into the rationality of preventive use of anticoagulants,low molecular weight heparin,warfarin and aspirin in deep vein thrombosis(DVT)based on the perspective of drug quality control.METHODS:Retrospective analysis method was used to randomly extracted 300 patients with orthopaedic surgery in the Second Affiliated Hospital of Xinjiang Medical University in 2021 as the research objects.Based on information system of the hospital,relevant information such as gender,age,surgical type and prescription issuance were collected.The use of anticoagulants was recorded,the preventive medication of patients with different characteristics was analyzed,the prevention of DVT by various anticoagulants was compared,and the use rationality of anticoagulants was evaluated.RESULTS:Of the 300 patients with orthopaedic surgery,287 cases used preventive anticoagulants,with the usage rate of 95.67%.Among the 287 patients receiving preventive anticoagulants,125 cases(43.55%)were treated with low molecular weight heparin alone,65 cases(22.65%)were treated with low molecular weight heparin combined with warfarin,34 cases(11.85%)were treated with low molecular weight heparin combined with aspirin,and 34 cases(11.85%)were treated with warfarin alone,29 cases(10.10%)were treated with aspirin alone.There were 156 male patients(54.36%)and 131 female patients(45.64%).Patients≤40,>40 to 60,>60 to 75 and>75 years old were 35 cases(12.20%),103 cases(35.89%),139 cases(48.43%)and 10 cases(3.48%),respectively.Among different surgical types,total hip arthroplasty,total knee arthroplasty and hip fracture surgery were used in 209 cases(72.82%),29 cases(10.10%),and 49 cases(17.07%),respectively.The efficacy of warfarin alone and low molecular weight heparin alone in preventing DVT was better than that of aspirin alone,yet the difference was not statistically significant(P>0.05).The efficacy of low molecular weight heparin combined with warfarin and low molecular weight heparin combined with aspirin in preventing DVT was better than t

关 键 词：药品质量控制 预防性用药 抗凝血药 深静脉血栓 合理用药 

分 类 号：R969.3[医药卫生—药理学] R973.2[医药卫生—药学]