临床药师参与下需使用华法林抗凝治疗患者的临床药学实践  

Clinical pharmacy practice in patients requiring warfarin anticoagulant with the involvement of clinical pharmacists

作　　者：程宇晴 蔡高杰 朱辉 古再丽努尔·阿布都柯尤木 李志 吕会斌 CHENG Yuqing;CAI Gaojie;ZHU Hui(Department of Pharmacy,the Second People's Hospital of Kashgar Region,Xinjiang,Kashgar 844000,China;不详)

机构地区：[1]新疆维吾尔自治区喀什地区第二人民医院药学部,844000 [2]新疆维吾尔自治区喀什地区第二人民医院麻醉科,844000

出　　处：《河北医药》2025年第3期505-508,共4页Hebei Medical Journal

基　　金：新疆药学会科研基金项目(编号:+YXH202220)。

摘　　要：目的探讨需使用华法林抗凝治疗患者临床药师参与下的临床药学实践。方法研究对象是通过医院HIS信息系统收集2023年1月至2023年6月住院期间服用华法林的患者共53例,由临床药师进行日常监测和华法林剂量调整。同时选取该阶段由临床医生参与下的用药患者53例作为对照,总纳入人数为106例。记录患者适应证、基线资料、服用华法林用法用量及时间、目标范围、调整剂量、住院天数等。结果试验组患者达到稳态时间短于对照组(P<0.05),INR达标时间短于对照组(P<0.05),出院时INR达标率79.25%(42/53)高于对照组35.85%(19/53)(P<0.05),抗凝质量差比例3.77%(2/53)低于对照组41.51%(22/53),抗凝治疗有效、抗凝治疗质量较好比例[16.98%(9/53)、79.25%(42/53)]均高于对照组[11.32%(6/53)、47.17%(25/53)](Z=4.011,P<0.05)。试验组患者血栓或出血事件发生率[5.66%(3/53)]低于对照组[26.42%(14/53)](χ^(2)=8.477,P<0.05),抗凝知识知晓率高于对照组(P<0.05)。结论需使用华法林抗凝治疗患者临床药师参与下的临床药学实践效果好。Objective To explore the clinical pharmacy practice of patients requiring warfarin anticoagulant therapy with the participation of clinical pharmacists.Methods A total of 53 patients medicated with warfarin during hospitalization from December 2022 to May 2023 were recruited through the hospital HIS information system.Clinical pharmacists conducted daily monitoring and dose adjustment of warfarin.A total of 53 patients taking warfarin with the participation of clinicians during the same period were selected as in the experimental group.Thus,106 patients were finally included in the present study.The indications,baseline data,dosage and time of warfarin administration,target range,adjusted dose and length of stay were recorded.Results The time to achieve homeostasis and the time of international normalized ratio(INR)reaching the standard of patients in the experimental group were significantly shorter than those of the control group(P<0.05).The rate of INR reaching the standard at discharge was significantly higher in the experimental group than the control group(79.25%[42/53]vs 35.85%[19/53],P<0.05).The proportion of poor anticoagulant quality was significantly lower in the experimental group than the control group(3.77%[2/53]vs 41.51%[22/53]),and the proportions of effective anticoagulant treatment(16.98%[9/53]vs 11.32%[6/53])and good anticoagulant quality(41.51%[22/53]vs 79.25%[42/53])were significantly higher than those of the control group(Z=4.011,P<0.05).The incidence of thrombotic or bleeding events in the experimental group was significantly lower than that of the control group(5.66%[3/53]vs 26.42%[14/53],χ^(2)=8.477,P<0.05),and the awareness rate of anticoagulation knowledge was significantly higher than that in the control group(P<0.05).Conclusion The clinical pharmacy practice with the participation of clinical pharmacists in warfarin anticoagulant therapy is effective.

关 键 词：华法林抗凝治疗 临床医师参与 临床药师参与 临床药学实践 

分 类 号：R973.2[医药卫生—药品]