门诊长期服用华法林老年患者药物服用情况及管理

Medicine and management of Warfarin in elderly outpatients

目的了解门诊长期服用华法林药物的老年患者药物服用情况，分析药物应用中存在的问题，提出改进措施。方法调查23例门诊服用华法林的老年患者服药情况，观察血凝血酶原时间（PT）及国际标准化比率（INR）、大便潜血、尿常规化验值及药物不良反应情况。结果23例患者在服用华法林药物过程中，出血发生率17．39％，国际标准化比率（INR）达标率46．34％，不达标率53．66％，超标率2．25％。以80岁为界的两组患者，出血、大便潜血阳性、镜下血尿情况比较差异无统计学意义（P〉0．05）。结论加强门诊对服用华法林老年患者的随访和健康教育，提高门诊复诊率，是预防并发症的有效手段。

Objective To find out the long-term medication situation of Warfarin in elderly outpatients, to analyze the problems existed in the medication application and present improvement actions. Methods Based on the 23 cases of elderly patients who were taking Warfarin for various reasons, blood prothrombin time （PT）, international normalized ratio （INR）, the result of fecal occult blood test, urine routine test and the adverse reactions were investigated. Results In the 23 patients, the incidence rate of hemorrhage was 17.39%, the International normalized ratio （INR）, under standard rate and over standard rate were 46. 34%, 53.66% and 2. 25% respectively. Tile patients were divided into two groups based on the age of 80-year-old and Fisher exact test was used for data analysis. The incidence rates of hemorrhage, the results of fecal occult blood test and microscopic hematuria test were not statistically significant between two groups （P 〉 O. 05）. Condusions Strengthening follow-up and health education and improving subsequent consultation in elderly outpatients taking Warfarin are effective measures to prevent the comolieations.