摘要
目的了解我院住院患者华法林临床应用情况,总结临床用药经验,为临床用药提供参考,促进临床合理用药,探讨开展华法林临床药学监护的意义。方法查阅我院2009年1～12月应用华法林的住院患者病历115份,并对华法林临床应用的适应证、用药剂量、INR监测、出血并发症及合并用药等进行系统的回顾性调查分析。结果我院华法林的主要应用于心房颤动、深静脉血栓、起搏器或静脉支架植入术后等。住院患者华法林用量范围为0.625～7.5mg,平均日剂量2.45±0.81mg。INR波动于0.92～7.01。其中INR<1.5的病例占33.0%,INR为1.5～3.0的病例占44.3%,INR>3.0的病例占22.6%。华法林应用中出现出血并发症有尿潜血、脑出血、腰大肌出血,其总发生率为25.2%。出现出血并发症的病例中合并用药主要有抗凝药物、中成药、抗菌药物、胃黏膜保护药等。结论目前华法林的临床应用仍存在不足,积极开展华法林临床药学监护具有重要意义。临床药师将与医师一起共同创建安全、经济、有效的华法林用药体系。
Objective To investigate the clinical application of warfarin in patients of our hospital,summarize the experiences of its application,promote the rational use of warfarin.and probe the importance of the pharmaceutical care of warfarin.Methods 115 cases history of patients with warfarin in our hospital between 2009.1-2009.12 were consulted,to retrospectively analyze the indication,dosage,international normalized ratio（INR）,hemorrhage event,and drugs used in combination with warfarin systematically.Results The common clinical indications for warfarin use were atrial fibrillation,deep vein thrombosis,cardiac pacemaker and venous stenting et al.The dosage of Warfarin used in patients was between 0.625-7.5mg.The average daily dosage was 2.45±0.81mg.The INR fluctuated between 0.92-7.01.The patients with INR1.5 accounted for 33.0%,the cases with INR between 1.5-3.0 accounted for 44.3%,and the cases with INR3.0 accounted for 22.6%.The hemorrhage events happened in patients with warfarin were hematuria,cerebral hemorrhage and psoas hemorrhage.Its incidence was 25.2%.The cases with hemorrhage commonly took warfarin combined with other drugs,such as anticoagulant drugs,Chinese patent medicines,antibacterials,gastric mucosal protective drugs.Conclusion At present,the clinical application of warfarin is still deficient.It is significant to develop the pharmaceutical care of warfarin activelic.The clinical pharmacists and physicians should make a concerted effort to build a safe,ecnomy and effective medication system for warfarin application.
出处
《中国药物警戒》
2011年第9期524-527,共4页
Chinese Journal of Pharmacovigilance
关键词
华法林
临床应用
调查分析
药学监护
warfarin
clinical application
investigation
pharmaceutical care
