【摘要】：目的:探討循證藥學(xué)在連續(xù)性腎臟替代治療(CRRT)期間抗凝藥物治療中協(xié)助實(shí)施最佳治療方案的作用。方法:以1例患者行CRRT期間出現(xiàn)血小板減少時(shí)抗凝藥物治療決策為例,介紹臨床藥師介入臨床,通過(guò)循證藥學(xué)方法結(jié)合臨床數(shù)據(jù),分析高出血風(fēng)險(xiǎn)及血小板減少患者行CRRT期間選用阿加曲班抗凝治療的證據(jù),并跟蹤其療效和安全性,對(duì)藥物治療過(guò)程進(jìn)行綜合評(píng)估的相關(guān)情況。結(jié)果:分析檢索到高出血風(fēng)險(xiǎn)及血小板減少患者行CRRT期間選用阿加曲班抗凝治療的文獻(xiàn)共5篇,其中有1篇系統(tǒng)評(píng)價(jià)、1篇隨機(jī)對(duì)照研究、3篇列隊(duì)研究。將其最佳證據(jù)應(yīng)用到該例患者的臨床實(shí)踐中并取得了較好效果,患者血小板和凝血指標(biāo)改善,無(wú)出血和栓塞并發(fā)癥發(fā)生。結(jié)論:循證藥學(xué)在CRRT期間抗凝治療決策中可發(fā)揮重要作用。
[Abstract]:Objective: to investigate the role of evidence-based pharmacology in the implementation of the best therapeutic regimen in the treatment of continuous renal replacement therapy (CRRT) during anticoagulant therapy. Methods: taking one patient with thrombocytopenia during CRRT as an example, the intervention of clinical pharmacists and clinical data were introduced. To analyze the evidence of Agatripine anticoagulant therapy in patients with high risk of hemorrhage and thrombocytopenia during CRRT, and to follow up its efficacy and safety, and to evaluate the process of drug therapy. Results: a total of 5 papers were collected from the patients with high risk of hemorrhage and thrombocytopenia who were treated with Agatripine anticoagulant therapy during CRRT, including 1 systematic evaluation and 1 randomized controlled study and 3 separate studies. The best evidence was applied to the clinical practice of the patient and good results were obtained. The platelet and coagulation indexes were improved without bleeding and embolization complications. Conclusion: Evidence-based pharmacology may play an important role in anticoagulant therapy decision making during CRRT.
【作者單位】： 南京醫(yī)科大學(xué)附屬蘇州醫(yī)院藥學(xué)部;上海交通大學(xué)醫(yī)學(xué)院附屬新華醫(yī)院藥學(xué)部;
【分類(lèi)號(hào)】：R459.5

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