胸部恶性肿瘤围手术期抗凝药物预防静脉血栓栓塞症的回顾性分析

Retrospective Analysisof Perioperative Venous Thromboembolism Prophylaxis in Thoracic Cancer Patients

目的:回顾性分析胸部恶性肿瘤围手术期使用抗凝药物预防静脉血栓栓塞症的现状及其合理性,探讨临床药学服务在肿瘤患者静脉血栓栓塞症预防中应发挥的积极作用。方法:查阅2019年6~12月某三甲综合医院胸部恶性肿瘤围术期住院患者195例的临床资料,对患者基本情况,Caprini风险评估量表、抗凝药物使用情况及其合理性等进行统计和评价。结果:195例患者的总体抗凝药物预防使用率为47.7%(93/195);根据Caprini量表评分列为中、高危患者的抗凝药物预防使用率分别为24.2%和53.5%。抗凝药物预防使用不合理率为68.8%(64/93),主要表现为用药时机过迟和疗程较短。结论:该医疗机构胸部恶性肿瘤患者围术期使用抗凝药物预防静脉血栓栓塞症的比例偏低,且存在不合理用药情况,提示临床药师应利用自身专业技能,协助医师建立正确的抗凝意识,从而提高医疗机构肿瘤患者静脉血栓栓塞症防治的规范性和合理性。

Objective:To analyze the characteristics and rationality of perioperative venous thromboembolism prophylaxis in thoracic cancer patients retrospectively,and then to discuss how to play the positive role of clinical pharmacist.Methods:A total 195 inpatients with thoracic cancer from June 1st,2019 to December 31st,2019 were reviewed.The basic characteristics,scores of the Caprini risk assessment scale,and the use of anticoagulant drugs were recorded and analyzed.Results:The total proportion of prophylactic anticoagulant drugs in perioperative thoracic cancer inpatients was 47.7%(93/195).Based on the Caprini risk assessment scale,the proportion of prophylactic anticoagulant drugs in the middle-and high-risk groups were 24.2%and 53.5%,respectively.Meanwhile,the number of irrational drug use accounted for 68.8%(64/93),mainly for the inappropriate timing and course of medication.Conclusion:The proportion of prophylactic anticoagulant drugs in thoracic cancer patients is low,and there is unreasonable use in some cases.Therefore,clinical pharmacists should assist physicians to strengthen the awareness of perioperative venous thromboembolism prophylaxis and the rational drug use of anticoagulant drugs by their own professional skills,as so to improve the standardization and rationality of venous thromboembolism prophylaxis in cancer patients.