基于指南制定的标准化药学干预在慢性心力衰竭患者治疗与管理中的应用效果

Application effect of standardized pharmaceutical intervention based on guidelines in the treatment and management of chronic heart failure patients

目的 观察基于指南制定的标准化药学干预在慢性心力衰竭(CHF)患者治疗与管理中的应用效果。方法 选取2020年7月-2021年2月徐州医科大学附属医院心血管内科和CCU收治的CHF患者100例,根据干预方法将患者分为常规组50例和药学干预组50例。常规组患者采用普通的常规监护,药学干预组患者采用基于指南制定的标准化药学干预。比较2组患者住院时间、10 d后出院情况、转归(好转、未好转)、心功能分级、临床检查指标[左心室射血分数(LVEF)、N末端脑钠肽前体(NT-proBNP)、天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、白蛋白(Alb)、总胆红素(TBi L)、血肌酐(SCr)、估算肾小球滤过率(e GFR)、血糖(GLU)、血清钾、低密度脂蛋白胆固醇(LDL-C)、糖化血红蛋白(Hb A)]、治疗费用及药品不良反应(ADR)发生率。结果 药学干预组住院时间短于常规组,10 d后出院率、疾病好转率高于常规组(P<0.05)。药学干预组LVEF优于常规组,NT-proBNP、ALT、GLU、血清钾、Hb A低于常规组,e GFR高于常规组(P<0.05)。药学干预组住院总费用、护理费用、西药费用少于常规组(P<0.05)。药学干预组ADR总发生率为14.0%,低于常规组的32.0%(χ^(2)=4.574,P=0.032)。结论 基于指南制定的标准化药学干预能够有效改善CHF患者的血糖及肝肾功能,缩短住院时间,提高疾病好转率,减少ADR发生,进而减轻患者家庭的经济负担。

Objective To explore the application effect of standardized pharmaceutical intervention based on guidelines in the treatment and management of chronic heart failure(CHF) patients.Methods From July 2020 to February 2021,100 patients with CHF admitted to the Department of Cardiovascular Medicine and CCU of Affiliated Hospital of Xuzhou Medical University were selected,and they were divided into conventional group and pharmaceutical intervention group,50 cases in each group.Patients in conventional group were given ordinary routine monitoring,patients in pharmaceutical intervention group were given standardized pharmaceutical intervention based on guidelines.Length of stay,discharge status after 10 days,outcome(improved,not improved),cardiac function classification,clinical examination indexes(LVEF,NT-proBNP,AST,ALT,Alb,TBi L,SCr,e GFR,GLU,K,LDL-C,Hb A),treatment expenses,incidence of ADR were compared between the two groups.Results The pharmaceutical intervention group of length of stay was shorter than that in conventional group,discharge rate after 10 days,disease improved rate were higher than those in conventional group(P<0.05).The pharmaceutical intervention group of LVEF was better than that in conventional group,NT-proBNP,ALT,GLU,K,Hb Awere lower than those in conventional group,e GFR was higher than that in conventional group(P<0.05).The pharmaceutical intervention group of total hospitalization expenses,nursing expenses and western medicine expenses were less than those in conventional group(P<0.05).Incidence of ADR in pharmaceutical intervention group was 14.0%,which was lower than 32.0%of conventional group(χ^(2)=4.574,P=0.032).Conclusion Standardized pharmaceutical intervention based on guidelines can effectively improve GLU and liver and kidney function of CHF patients,shorten hospitalization time,promote disease improved rate,reduce ADR,and reduce the financial burden of patients’families.