某院住院患者抗凝防治现况调查与评价  

Investigation and evaluation of the current situation of anticoagulation prevention and treatment of inpatients in a hospital

作　　者：梁侠兵 凡保华 文志萍 王晓义[2] Liang Xiabing;Fan Baohua;Wen Zhiping;Wang Xiaoyi(School of Pharmacy,Shihezi University,Shihezi 832003;Department of Pharmacy,the First Affiliated Hospital of Shihezi University,Shihezi 832000)

机构地区：[1]石河子大学药学院,新疆石河子832003 [2]石河子大学第一附属医院药学部,新疆石河子832000

出　　处：《中国现代医药杂志》2025年第3期21-26,共6页Modern Medicine Journal of China

基　　金：石河子大学自然科学基金项目(编号:ZZZC2023055)。

摘　　要：目的调查和分析石河子大学第一附属医院(以下简称“我院”)住院患者VTE防治现状和抗凝药物的使用情况,为进一步规范抗凝防治策略提供数据参考。方法对我院2023年12月11~20日出院的成年患者进行VTE风险评估并对其抗凝防治现状开展横断面调查。调查项目包括患者一般情况、VTE评分、诊断方法、伴发疾病、预防措施、治疗方法、给药方案等,并对用药合理性、有效性和安全性进行评估。结果共纳入1633例患者,其中343例给予抗凝药物,包括注射类抗凝药和口服抗凝药,其中315例(19.29%)抗凝预防,28例(1.71%)VTE确诊患者抗凝治疗。在外科,5.4%的VTE低危患者使用了抗凝药物预防,VTE高危患者采取物理预防仅占22.4%,有58.0%的VTE高危患者未使用抗凝药物预防。在内科,3.0%的VTE低危患者使用了抗凝药物预防,VTE高危患者采取物理预防仅占5.0%,有44.6%的VTE高危患者未使用抗凝药物预防。分别有17.9%的VTE患者未足疗程抗凝治疗和34.2%的房颤患者未给予抗凝治疗;有14.3%的VTE患者和12.0%的NVAF患者利伐沙班抗凝剂量不足,包括高龄、联用抗血小板药物、患者依从性差、肾功能减退和存在高出血风险等情况;53.6%的VTE患者LMWH给药未基于体质量且抗凝剂量不足。住院期间VTE全因死亡率为21.4%。住院期间VTE患者抗凝治疗ADR发生率为17.9%、预防患者发生率为2.9%。结论我院抗凝药物临床应用广泛,但VTE高危患者物理预防实施率、抗凝药物预防实施率有待进一步提升;VTE和NVAF患者存在未抗凝现象,利伐沙班和LMWH抗凝应用剂量存在不足。抗凝患者长期防治安全性与有效性未知。Objective To investigate and analyze the current situation of VTE anticoagulation prevention and treatment,and the use of anticoagulants in hospitalized patients in the First Affiliated Hospital of Shihezi University(hereinafter refferred to as"our hospital"),in order to provide data reference for further standardizing anticoagulation prevention and treatment strategies.Methods A cross-sectional survey was conducted on the VTE risk assessment and anticoagulation prevention and treatment status of adult patients discharged from our hospital from Dec 11th to 20th,2023.The survey items included the patients'general information,VTE scores,diagnostic methods,concomitant diseases,preventive measures,treatment methods,and dosing scheme,etc.,and the rationality,effectiveness,and safety of medication were evaluated.Results A total of 1633 patients were enrolled,of which 343 patients were given anticoagulant drugs,including injectable anticoagulants and oral anticoagulants.Among them,315 patients(19.29%)received anticoagulant prophylaxis,and 28 patients(1.71%)diagnosed with VTE received anticoagulant therapy.In surgery,5.4%of low-risk VTE patients used anticoagulant prophylaxis,while only 22.4%of high-risk VTE patients received physical prophylaxis,and 58.0%of high-risk VTE patients did not use anticoagulant prophylaxis.In internal medicine,3.0%of low-risk patients used anticoagulants for prevention,while only 5.0%of high-risk VTE patients used physical prophylaxis.44.6%of high-risk VTE patients didn't use anticoagulants for prevention.17.9%of VTE patients did not receive full course anticoagulant therapy,and 34.2%of atrial fibrillation patients did not receive anticoagulant therapy.14.3%of VTE patients and 12.0%of NVAF patients had insufficient doses of rivaroxaban anticoagulant,including advanced age,concomitant use of antiplatelet drugs,poor patient compliance,renal dysfunction,and high bleeding risk;53.6%of VTE patients did not receive LMWH based on weight and insufficient anticoagulant dosage.The all-cause mortality r

关 键 词：抗凝药物 静脉血栓栓塞症 心房颤动 抗凝 治疗 预防 

分 类 号：R54[医药卫生—心血管疾病]