目的评估临床药师通过进行用药教育、解答抗凝用药咨询等,参与肺栓塞患者抗凝治疗管理的效果。方法以2015年3月至2017年4月于北京朝阳医院呼吸科住院的肺栓塞患者共计204例为研究对象,比较药师教育组(干预组)与其他未接受药师教育组(对...目的评估临床药师通过进行用药教育、解答抗凝用药咨询等,参与肺栓塞患者抗凝治疗管理的效果。方法以2015年3月至2017年4月于北京朝阳医院呼吸科住院的肺栓塞患者共计204例为研究对象,比较药师教育组(干预组)与其他未接受药师教育组(对照组)INR在目标范围时间的百分比(the percentage of INRs within the therapeutic range,TTR)、INR在扩大范围内时间百分比(the percentage of INRs within the expanded range,TER)、INR监测间隔时间、出血事件、再次住院率及急诊就诊率。结果干预组的TTR和TER分别为(70.89±26.02)%和(87.71±20.01)%,INR达标率显著高于对照组的(47.79±22.31)%和(71.23±21.47)%(P=0.000);干预组的INR监测间隔时间为(27.48±12.81)d,较对照组(43.35±13.65)d有显著缩短(P=0.000)。对照组及干预组患者的总出血事件(41.96%vs 29.35%,P=0.062)、严重出血事件(3.57%vs 2.17%,P=0.864)和轻微出血事件(38.39%vs 27.17%,P=0.091),差异均无统计学意义。干预组患者院外的急诊就诊次数显著低于对照组(9.82%vs 1.09%,P=0.008),两组患者再次入院率无明显差异(8.04%vs2.17%,P=0.125)。结论临床药师参与肺栓塞患者抗凝治疗管理可帮助患者更规律地监测INR,提高INR达标率,减少出院后的急诊就诊频次。展开更多
Background Acute exacerbation of chronic obstructive pulmonary disease （COPD） is always associated with a high incidence and mortality. Because of the presence of some concomitant risk factors such as immobilization...Background Acute exacerbation of chronic obstructive pulmonary disease （COPD） is always associated with a high incidence and mortality. Because of the presence of some concomitant risk factors such as immobilization, bronchial superinfection, patients who are admitted for acute exacerbations of COPD are generally considered to be at moderate risk for the development of venous thromboembolism. In this study, we investigated the prevalence and the clinical manifestations of deep venous thrombosis （DVT） in patients with acute exacerbation of COPD.Methods From March 2007 to March 2009, 520 consecutive patients were included in this study. On admission, color Doppler ultrasound of lower extremities in all cases was performed for diagnosing DVT. Patients with DVT were compared with those without DVT from such aspects as demographics, symptoms, physical signs and risk factors.Results Among the 520 patients, DVT was found in 46 cases （9.7%）. In patients with DVT, the duration of hospitalization was longer （P=0.01）, and the mechanical ventilation requirement increased （P 〈0.001）. Other indicators for patients with more possibility of DVT were immobility exceeding 3 days （P 〈0.001）; pneumonia as concomitance （P=0.01）; respiratory failure type Ⅱ （P=0.013）; current smoking （P=0.001）. Lower extremity pain was more common in DVT cases in comparison to those without DVT （34.8% vs. 15.2%, P=0.01 ）.Conclusions The acute exacerbation of COPD patients, who were immobilized for over 3 days, complicated by pneumonia and had respiratory failure type Ⅱ, had a higher risk of DVT. In addition, DVT detection awareness should be increased in cases that had a lower extremity pain.展开更多
文摘目的评估临床药师通过进行用药教育、解答抗凝用药咨询等,参与肺栓塞患者抗凝治疗管理的效果。方法以2015年3月至2017年4月于北京朝阳医院呼吸科住院的肺栓塞患者共计204例为研究对象,比较药师教育组(干预组)与其他未接受药师教育组(对照组)INR在目标范围时间的百分比(the percentage of INRs within the therapeutic range,TTR)、INR在扩大范围内时间百分比(the percentage of INRs within the expanded range,TER)、INR监测间隔时间、出血事件、再次住院率及急诊就诊率。结果干预组的TTR和TER分别为(70.89±26.02)%和(87.71±20.01)%,INR达标率显著高于对照组的(47.79±22.31)%和(71.23±21.47)%(P=0.000);干预组的INR监测间隔时间为(27.48±12.81)d,较对照组(43.35±13.65)d有显著缩短(P=0.000)。对照组及干预组患者的总出血事件(41.96%vs 29.35%,P=0.062)、严重出血事件(3.57%vs 2.17%,P=0.864)和轻微出血事件(38.39%vs 27.17%,P=0.091),差异均无统计学意义。干预组患者院外的急诊就诊次数显著低于对照组(9.82%vs 1.09%,P=0.008),两组患者再次入院率无明显差异(8.04%vs2.17%,P=0.125)。结论临床药师参与肺栓塞患者抗凝治疗管理可帮助患者更规律地监测INR,提高INR达标率,减少出院后的急诊就诊频次。
文摘Background Acute exacerbation of chronic obstructive pulmonary disease （COPD） is always associated with a high incidence and mortality. Because of the presence of some concomitant risk factors such as immobilization, bronchial superinfection, patients who are admitted for acute exacerbations of COPD are generally considered to be at moderate risk for the development of venous thromboembolism. In this study, we investigated the prevalence and the clinical manifestations of deep venous thrombosis （DVT） in patients with acute exacerbation of COPD.Methods From March 2007 to March 2009, 520 consecutive patients were included in this study. On admission, color Doppler ultrasound of lower extremities in all cases was performed for diagnosing DVT. Patients with DVT were compared with those without DVT from such aspects as demographics, symptoms, physical signs and risk factors.Results Among the 520 patients, DVT was found in 46 cases （9.7%）. In patients with DVT, the duration of hospitalization was longer （P=0.01）, and the mechanical ventilation requirement increased （P 〈0.001）. Other indicators for patients with more possibility of DVT were immobility exceeding 3 days （P 〈0.001）; pneumonia as concomitance （P=0.01）; respiratory failure type Ⅱ （P=0.013）; current smoking （P=0.001）. Lower extremity pain was more common in DVT cases in comparison to those without DVT （34.8% vs. 15.2%, P=0.01 ）.Conclusions The acute exacerbation of COPD patients, who were immobilized for over 3 days, complicated by pneumonia and had respiratory failure type Ⅱ, had a higher risk of DVT. In addition, DVT detection awareness should be increased in cases that had a lower extremity pain.
