临床药师对恶性肿瘤合并肾功能不全患者的干预效果观察

Intervention efficacy of clinical pharmacists on patients with malignant tumor and renal insufficiency

目的探讨临床药师在恶性肿瘤合并肾功能不全患者抗肿瘤治疗中的作用。方法将110例恶性肿瘤合并肾功能不全患者按照随机分配原则纳入干预组和对照组,临床药师参与干预组患者抗肿瘤方案的制定,监测药物治疗过程,对不合理的治疗及时干预,避免药物不良反应及不良相互作用;对照组通过医院信息系统回顾性调查收集相关资料。结果排除混杂因素的干扰后,干预组患者抗肿瘤治疗后肾功能较治疗前有显著改善,且与对照组治疗后相比亦有显著改善,差异有统计学意义(P<0.01)。干预组平均住院费用显著低于对照组(P<0.05),不良反应发生率及临床使用不合理率也显著低于对照组(P<0.05)。临床用药合理性调查发现,未根据肾损害程度进行药物剂量调整是对照组存在的主要问题。结论对于恶性肿瘤合并肾功能不全患者,科学合理地开展药学干预,可大大提高药物治疗的安全性、有效性及合理性,给患者带来更多获益。

Objective To evaluate the role of clinical pharmacists in the treatment of malignant tumor patients complicated with renal insufficiency.Methods A total of 110 patients with malignant tumors and renal insufficiency were selected and randomly allocated into the intervention group and the control group.For patients in the intervention group,clinical pharmacists drew up the anti-tumor medicinal plan,monitored the process of drug treatment,and intervened in time for unreasonable treatment,to avoid adverse drug reactions and adverse drug interactions.Data of patients in the control group were collected and analyzed retrospectively based on the hospital information system.Results After excluding the interference of confounding factors,the renal function of the intervention group after anti-tumor treatment was significantly improved as compared with that before treatment,and it was also significantly improved as compared with the control group after treatment,and the difference was statistically significant(P<0.01).The average hospitalization expenses of patients in the intervention group was markedly lower than that of the control group(P<0.05).Moreover,the incidence of adverse reactions and the rate of irrational drug use in the intervention group were significantly lower than those in the control group(P<0.05).Investigations on the rationality of drug use found that the main problem in the control group was the irrational drug dose due to lacking consideration of renal insufficiency.Conclusion For patients with malignant tumor and renal insufficiency,rational pharmaceutical intervention in due time can help to promote the rationality,safety and effectiveness of drug use,and bringing more benefits to patients.