基于MTM模式下临床药师参与脊柱外科围手术期氨甲环酸与抗凝血药应用的实践  

The impact of clinical pharmacists′ involvement in the perioperative administration of tranexamic acid and anticoagulants in spinal surgery under the MTM model

作　　者：狄会峰 刘会 韩静 申立林 伊娜 闫莹 DI Huifeng;LIU Hui;HAN Jing;SHEN Lilin;YI Na;YAN Ying(Jinan City People′s Hospital,Jinan 271100,China)

机构地区：[1]济南市人民医院,山东济南271100

出　　处：《药学研究》2024年第12期1245-1248,共4页Journal of Pharmaceutical Research

基　　金：山东省医学会临床药学科研专项基金项目(No.YXH2021ZX014)。

摘　　要：目的基于药物治疗管理(MTM)模式下以“以患者为中心”开展药学服务,探讨临床药师参与对脊柱外科围手术期氨甲环酸与抗凝血药应用,以减少患者失血量,缩短住院时间,保障医疗安全。方法采用历史对照研究方法,纳入脊柱外科135例手术病例,通过采集患者病历资料,抗凝血药物应用种类、氨甲环酸与抗凝血药合理使用情况、药物使用时机选择,以评估临床药师药学干预效果。结果临床药师参与药学服务后,氨甲环酸溶媒选择合格率、术前给药时机正确率、抗凝血药物使用合格率明显升高,总失血量降低,差异均具有统计学意义(P<0.05)。结论临床药师参与脊柱外科围手术期氨甲环酸与抗凝血药管理,可提高围手术期用药合理率,达到止血与抗凝的平衡,有助于医疗管理质量提升。Objective To carry out pharmaceutical care based on the"patient-centered"approach under the MTM model,and explore the involvement of clinical pharmacists in the application of tranexamic acid and anticoagulants in spinal surgery perioperative period,in order to reduce blood loss,shorten hospitalization time,and ensure medical safety.Methods A historical control study was conducted,including 135 cases of spinal surgery.By collecting patients′medical records,the types of anticoagulant drugs used,the rational use of tranexamic acid and anticoagulants,and the timing of drug use were analyzed to evaluate the effect of clinical pharmacist intervention.Results After clinical pharmacists participated in pharmaceutical care,the qualified rate of tranexamic acid solvent selection,the correct rate of preoperative medication timing,and the qualified rate of anticoagulant drug use significantly increased,while the total blood loss decreased.The differences were statistically significant(P<0.05).Conclusion The participation of clinical pharmacists in the management of tranexamic acid and anticoagulants in spinal surgery perioperative period can improve the rationality of perioperative medication,achieve a balance between hemostasis and anticoagulation,and help improve the quality of medical management.

关 键 词：脊柱外科 围手术期 氨甲环酸 抗凝血药物 药学服务 

分 类 号：R969.4[医药卫生—药理学]