多发性骨髓瘤病人血栓预防情况的调查分析

Current application of anticoagulant therapy with multiple myeloma

目的回顾性分析多发性骨髓瘤行化疗的病人预防性抗凝治疗情况及探讨临床药师在治疗中可开展的工作。方法选取昆明医科大学第二附属医院2016年1—12月期间诊断为多发性骨髓瘤,并进行化疗的79份住院病历,调查其预防性抗凝治疗方案,并进行评价分析。结果 89.87%行化疗的多发性骨髓瘤病人进行了预防性抗凝,其中沙利度胺或来那度胺联合化疗组病人接受预防性抗凝治疗的有50例,合理率为61.11%;非沙利度胺或来那度胺联合化疗组病人预防性抗凝治疗的有21例,合理率为64.00%。结论该院第二附属医院临床医生对于多发性骨髓瘤病人已有预防性抗凝的意识,但在预防性抗凝治疗方案选择方面仍有待提高。临床药师应加强相关知识的学习更新,积极参与静脉血栓栓塞风险评估及抗凝方案制定,规范肿瘤病人血栓预防,提高病人用药安全。

Objective To retrospectively analyze the current application of anticoagulant therapy in hospitalized patients with multiple myeloma,and to explore the key role of clinical pharmacists in this process.Methods A retrospective survey of anticoagulant therapy for 79 hospitalized patients with multiple myeloma who underwent chemotherapy in the Second Affiliated Hospital of Kunming Medical University from January to December 2016 was conducted,and the rationality of the prophylactic anticoagulation scheme was analyzed.Results The prophylactic anticoagulant therapy rate against venous thromboembolism was 89.87%for patients with multiple myeloma,who received chemotherapy.50 patients received prophylactic anticoagulant therapy in the combination of chemotherapy with Thalidomide or Lenalidomide group,and the reasonable rate was 61.11%;21 patients received prophylactic anticoagulant therapy in the non-Thalidomide or Lenalidomide plus chemotherapy group,while reasonable rate was 64.00%.Conclusions The awareness of prophylactic anticoagulant therapy for multiple myeloma patients has been primarily raised up among clinicians working in the Second Affiliated Hospital of Kunming Medical University,however,regimens for prophylactic anticoagulant therapy should be optimized.Moreover,much more attention should be paid by the clinic pharmacists in assessing risks and effectively managing the use of anticoagulant,with the purpose of building a safe and effective medication system for prophylaxis against venous thromboembolism.