本文選題：帶狀皰疹 + 臨床路徑�。� 參考：《山東大學(xué)》2016年碩士論文

【摘要】：目的：帶狀皰疹(Herpes zoster, HZ)是由水痘-帶狀皰疹病毒(Varicella-zoster virus,VZV)感染引起的皮膚病,為一種皮膚科的常見病。嚴(yán)重帶狀皰疹需住院治療,病人痛苦大,住院時(shí)間長,費(fèi)用高。為規(guī)范疾病診療、提高醫(yī)療質(zhì)量、降低醫(yī)療費(fèi)用,原國家衛(wèi)生部自2009年起開展了臨床路徑管理工作。建立某些疾病診療的臨床路徑管理,其中包括帶狀皰疹的臨床路徑管理。由于各類疾病臨床路徑是由不同的醫(yī)學(xué)專業(yè)學(xué)術(shù)組織建立的,因此對(duì)藥物的合理使用缺乏規(guī)范的、有效的、明確的要求,因此有必要配合疾病臨床診療的管理路徑,建立與之相匹配的藥學(xué)路徑,國內(nèi)外已有部分研究。本研究的目的在于建立與帶狀皰疹臨床路徑相匹配的藥學(xué)監(jiān)護(hù)路徑,從而有效規(guī)范帶狀皰疹治療過程中藥品的使用,降低藥物不良反應(yīng)(ADR)的發(fā)生,改善用藥依從性,降低藥品費(fèi)用,降低藥占比,降低患者住院費(fèi)用,縮短患者住院天數(shù),提高患者滿意度。方法：將入選病例分為試驗(yàn)組和對(duì)照組。對(duì)照組患者100例,為回顧性資料,患者僅接受臨床路徑管理相關(guān)的醫(yī)、護(hù)服務(wù),未接受臨床藥師的藥學(xué)服務(wù)；試驗(yàn)組患者100例,除接受臨床路徑的醫(yī)療服務(wù)外,還由專業(yè)臨床藥師按照藥學(xué)監(jiān)護(hù)路徑對(duì)其提供全程藥學(xué)服務(wù)。研究指標(biāo)包括住院費(fèi)用、藥品費(fèi)用、藥占比、治療藥物、用法用量、患者住院天數(shù)、ADR發(fā)生率、用藥依從性、患者滿意度等指標(biāo)。結(jié)果：試驗(yàn)組與對(duì)照組相比住院天數(shù)降低2.75天(P0.05)；住院費(fèi)用降低258.30元(P0.05)；藥品費(fèi)用降低724.69元(P0.05)；藥占比降低8.46%(P0.05)；藥品不良反應(yīng)發(fā)生率降低(P=0.03)。結(jié)論：1.建立與臨床路徑相結(jié)合帶狀皰疹住院患者藥學(xué)監(jiān)護(hù)路徑,可規(guī)范藥物使用,促進(jìn)合理用藥。2.對(duì)帶狀皰疹臨床路徑管理的住院患者同時(shí)實(shí)施藥學(xué)路徑管理,可降低住院費(fèi)用、藥品費(fèi)用和藥占比,縮短住院天數(shù),及時(shí)監(jiān)測(cè)、處置藥品不良反應(yīng)。3.藥學(xué)監(jiān)護(hù)路徑中臨床藥師介入藥物治療,可提高患者用藥依從性,提高患者滿意度,體現(xiàn)藥師的工作價(jià)值。
[Abstract]:Objective: Herpes zoster (HZ) is a common dermatologic disease caused by varicella-zoster virus (VZV) infection. Severe herpes zoster needs hospitalization treatment, patient pain is great, hospital stay is long, cost is high. In order to standardize the diagnosis and treatment of diseases, improve the quality of medical treatment, and reduce medical costs, the former Ministry of Health has carried out clinical path management since 2009. Establish clinical pathway management for some diseases, including herpes zoster. Because the clinical pathway of various diseases is established by different medical professional academic organizations, there is no standard, effective and clear requirement for the rational use of drugs, so it is necessary to cooperate with the management path of clinical diagnosis and treatment of diseases. Some studies have been done on the establishment of a matching pharmaceutical path at home and abroad. The purpose of this study is to establish a pharmaceutical monitoring pathway that matches the clinical pathway of herpes zoster, so as to effectively standardize the use of drugs in the treatment of herpes zoster, reduce the incidence of adverse drug reactions (ADR), and improve drug compliance. Reduce the drug cost, reduce the proportion of drugs, reduce the cost of hospitalization, shorten the days of hospitalization, improve the satisfaction of patients. Methods: the selected cases were divided into experimental group and control group. For the purpose of retrospective data, 100 patients in the control group received only the medical and nursing services related to clinical path management, but not the pharmacists, while in the experimental group, 100 patients received the medical care of the clinical pathway. Professional clinical pharmacists also provide full pharmaceutical care according to the path of pharmaceutical care. The study included hospitalization cost, drug ratio, therapeutic drugs, usage dosage, the incidence of ADR, compliance and satisfaction with drug use. Results: compared with the control group, the days of hospitalization in the trial group were 2.75 days lower than those in the control group, the hospitalization cost was reduced by 258.30 yuan (P 0.05), the drug cost was reduced by 724.69 yuan (P 0.05), the proportion of drugs was decreased by 8.46% (P 0.05), and the incidence of adverse drug reactions was decreased (P 0.03). Conclusion 1. The establishment of drug monitoring pathway combined with clinical pathway in patients with herpes zoster can standardize drug use and promote rational drug use. The application of pharmaceutical path management to the in-patients with herpes zoster clinical pathway management can reduce the hospitalization cost, drug cost and drug ratio, shorten the hospitalization days, timely monitor and deal with adverse drug reactions. 3. In the path of pharmaceutical monitoring, clinical pharmacists intervention in drug therapy can improve the compliance of patients with drugs, improve patient satisfaction, and reflect the work value of pharmacists.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R752.12

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 鄒曉蕾;曹棟;孫福生;楊旭;劉華強(qiáng);閆美興;;計(jì)劃剖宮產(chǎn)術(shù)藥學(xué)路徑的建立及效果[J];醫(yī)藥導(dǎo)報(bào);2013年11期

2 王英萍;張寧;;藥護(hù)合作模式在糖尿病病人健康教育中的應(yīng)用效果觀察[J];護(hù)理研究;2013年16期

3 齊曉漣;毛薇;唐靜;白向榮;孟莉;閆素英;王育琴;;臨床藥師參與癲癇臨床路徑實(shí)施效果的對(duì)照研究[J];中國藥房;2012年46期

4 孫靜;許建平;;臨床藥師參與糖尿病患者臨床路徑的效果觀察[J];醫(yī)學(xué)理論與實(shí)踐;2012年21期

5 魏翠芹;;臨床藥師在提高患者用藥依從性中的作用[J];中國醫(yī)藥指南;2012年25期

6 龐家蓮;蒙光義;唐華斌;;臨床路徑管理模式下的臨床藥師與合理用藥[J];中國藥房;2012年18期

7 張恩娟;陳琳;鄭曉媛;;臨床藥師在臨床路徑實(shí)施中的作用初探[J];中國藥房;2011年38期

8 錢進(jìn);;臨床藥師參與腦梗死臨床路徑的效果[J];實(shí)用臨床醫(yī)學(xué);2011年08期

9 何洪靜;張紅菊;夏培元;;臨床藥師在抗菌藥物合理應(yīng)用中的作用探討[J];中國藥房;2011年26期

10 褚燕琦;閆素英;賈丹;程紅勤;劉寧;王育琴;;臨床藥師在臨床路徑實(shí)施過程中圍手術(shù)期抗菌藥合理使用的干預(yù)作用[J];藥物流行病學(xué)雜志;2010年09期

，

本文編號(hào)：1935855