骨科大手术患者静脉血栓栓塞症预防全程化药学服务模式的构建及实践探索  

Construction and practice of full-course pharmaceutical care model for prevention of venous thromboembolism after major orthopedic surgery

作　　者：张立平[1] 杨春艳[2] ZHANG Liping;YANG Chunyan(Medical Department,Zaozhuang Municipal Hospital,Zaozhuang 277101,China;Pharmacy Department,Shengli Oilfield Central Hospital,Dongying 257034,China)

机构地区：[1]枣庄市立医院医务部,山东枣庄277101 [2]胜利油田中心医院药学部,山东东营257034

出　　处：《药学研究》2024年第9期918-921,共4页Journal of Pharmaceutical Research

基　　金：山东省医学会临床药学专项科研资助项目(No.YXH2019ZX027)。

摘　　要：目的构建骨科大手术患者静脉血栓栓塞症(VTE)预防全程化药学服务模式及工作方法,并探索其实践效果。方法选取2019年12月至2020年12月我院关节外科行骨科大手术的患者216例,采用随机数字表法分为对照组(108例)和干预组(108例)。对照组患者仅接受传统由医生、护士提供的医疗服务,干预组在对照组的基础上,临床药师参与围术期预防VTE药学服务中,并于出院后35 d内进行5次电话随访。比较两组患者VTE发生情况、出血发生情况、患者用药依从性、满意度、用药偏差,以及出院后药品不良事件(ADE)知晓程度。结果治疗期间干预组患者VTE发生率为5.55%,低于对照组的19.44%(P<0.01);干预组患者出血发生率为4.60%,低于对照组13.89%(P<0.05);干预组患者用药依从率、用药指导满意度、ADE知晓率均高于对照组;干预组患者用药偏差低于对照组。结论骨科大手术患者VTE预防全程化药学服务模式的构建,有利于提高患者用药依从性和降低VTE发生,值得推广。Objective To establish a full-course pharmaceutical care model and working method to prevent venous thromboembolism(VTE)in patients after major orthopedic surgery,and explore its practical effect.Methods 216 patients who underwent major orthopedic surgery were collected from joint surgery in our hospital during Dec.2019—Dec.2020,and then divided into control group(108 cases)and intervention group(108 cases)according to random number table.Patients in the control group only received traditional medical services provided by doctors and nurses.Patients in the intervention group,besides the basis of the control group,clinical pharmacists participated in the clinical pathway for VTE prevention,and provided standardized pharmaceutical services,and the patients were followed up 35 days after discharge.The incidence of VTE,bleeding,medication compliance,satisfaction,medication deviation,and awareness of adverse drug events(ADE)after discharge were compared between the two groups.Results The incidence of VTE in the intervention group was 5.55%,which was lower than 19.44%in the control group(P<0.01),and the incidence of bleeding in the intervention group was 4.60%,which was lower than 13.89%in the control group(P<0.05).The medication compliance rate,medication guidance satisfaction and ADE awareness rate of the patients in the intervention group were significantly higher than those in the control group;the medication deviation of the patients in the intervention group was significantly lower than that in the control group.Conclusion The full-course pharmaceutical care model and work method for prevention of VTE in patients undergoing major orthopedic surgery is conducive to improving patient medication compliance and reducing the incidence of VTE,which is worth popularizing.

关 键 词：临床药师 骨科大手术 静脉血栓栓塞症 药学服务 

分 类 号：R969.3[医药卫生—药理学]