冠心病患者经皮冠状动脉介入术后应用抗凝、抗血小板作用药物分析

Analysis of Anticoagulation and Antiplatelet Drugs in Patients with Coronary Heart Disease after PCI

目的:通过观察经皮冠状动脉介入(percutaneous coronary intervention,PCI)术后患者使用多种具有抗凝、抗血小板作用药物的状况,评价用药安全性。探讨药师随访指导出院患者用药,对提高患者用药依从性与安全性的作用。方法:回顾分析河南石油勘探局职工医院(以下简称"我院")2012年1月—2014年12月期间249例PCI患者的临床住院病历资料及随访资料478份。统计应用具有抗凝、抗血小板作用药物的品种数、疗程、给药剂量、发生的不良反应(出血、血小板计数降低、出血时间延长),分析其相关性。结果:具有抗凝、抗血小板作用的药物,联合品种多、疗程长、给药剂量大,患者年龄增大、基础疾病多,与发生出血相关不良反应的比例呈正相关。药师对出院患者的用药教育和指导,能提高患者用药的依从性,降低药物不良反应的发生率。结论:PCI术后患者联用多种具有抗凝、抗血小板作用的药物、疗程长、给药剂量大,可增加出血风险。对于高龄、合并基础疾病多的患者要加强用药监测。药师对患者进行用药随访教育,可确保患者用药安全。

OBJECTIVE： To evaluate the medication safety through the observation of postoperative application of anticoagulation and antiplatelet drugs in patients with coronary heart disease（ CHD） after PCI,and to probe into the effects of pharmacists＇ follow-up guidance of medication for discharged patients on the improvement of medication compliance and safety in patients. METHODS： The data of 249 medical records with PCI and 478 cases of follow-up in Workers＇ Hospital of Henan Petroleum Exploration Bureau（ hereinafter referred to as＂our hospital＂） from Jan. 2012 to Dec. 2014 were retrospectively analyzed. The categories of anticoagulation and antiplatelet drugs,treatmentcourse,administration dosage and the adverse reactions（ bleeding,thrombocytopenia,prolongation of bleeding time） were statistically recorded,among which the relevance was analyzed. RESULTS： The anticoagulation and antiplatelet drugs had a various of combination categories,long treatment course and a large administration dosage,for the patients with older age and many underlying diseases,which showed a positive correlation toward the incidence of adverse reactions associated with bleeding. The pharmacists＇ education and guidance on the discharged patients could improve the compliance of medication in patients and reduce the incidence of adverse drug reactions. CONCLUSIONS： For the anticoagulation and antiplatelet drugs had a various of combination categories,long treatment course and a large administration dosage,the application would increase the risk of bleeding after PCI. And it is important to strengthen the drug monitoring of patients with older age and many underlying diseases. Meanwhile,the follow-up education of drug use by pharmacists can ensure the patients＇ medication safety.