临床药师参与血液透析患者的药物治疗管理

Clinical Pharmacists Participated in Medication Therapy Management of Hemodialysis Patients

目的考察临床药师在血液透析患者药物治疗管理中的作用。方法采用对照研究方法,研究临床药师参与58名血液透析患者的药物治疗管理半年前后血压、血糖、血脂、肾性贫血和钙磷代谢的达标率变化情况。结果临床药师参与血液透析患者的用药管理后,血压达标率由32.76%上升至39.65%。血糖达标率由64.91%上升至71.92%。血红蛋白达标率由15.22%上升至30.43%。全段甲状旁腺素达标率由22.22%上升至26.67%。血磷达标率由24.56%上升至28.07%。但血钙达标率由52.63%下降至45.61%,钙磷乘积达标率由49.12%下降至40.35%。干预前后患者的血压、血糖、血红蛋白、钙磷代谢达标率均无显著性差异。胆固醇、甘油三脂和低密度脂蛋白胆固醇的达标率持平。结论临床药师参与血液透析患者的用药管理能促进患者对血压、血糖、血脂、肾性贫血和钙磷代谢的控制,同时能有效延缓并发症的发展和提高患者的生活质量。

OBJECTIVE To investigate the role of clinical pharmacists in drug treatment management of hemodialysis patients.METHODS A controlled study was conducted to study the changes of blood pressure,blood glucose,blood lipid,renal anemia and calcium and phosphorus metabolism in 58 hemodialysis patient before and after six-month medication therapy management by clinical pharmacists.RESULTS After clinical pharmacists participated in the administration of hemodialysis patients,the blood pressure control rate increased from 32.76%to 39.65%.The blood glucose control rate increased from 64.91%to 71.92%.The hemoglobin control rates increased from 15.22%to 30.43%.The parathyroid hormone control rate increased from 22.22%to 26.67%.The blood phosphorus control rate increased from 24.56%to 28.07%.However,the blood calcium control rate decreased from 52.63%to 45.61%,and the calcium phosphorus product control rate decreased from 49.12%to 40.35%.There was no significant difference in blood pressure,blood glucose,hemoglobin,calcium and phosphorus metabolism before and after treatment.The control rates of total cholesterol,triglycerides and LDL cholesterol remained the same.CONCLUSION The involvement of clinical pharmacists in medication management can promote the control of patients'blood pressure,blood glucose,blood lipid,renal anemia and calcium and phosphorus metabolism,and effectively delay the development of complications and improve the quality of life of patients.