發(fā)布時(shí)間：2019-06-19 07:31

【摘要】：目的口服抗凝藥物(OAC)聯(lián)合應(yīng)用香豆素、新抗凝劑治療血栓栓塞并發(fā)癥的效果非常顯著。然而,有研究表明,治療中經(jīng)常會(huì)出現(xiàn)抗凝劑使用過(guò)量或用量不足。本文探討長(zhǎng)期服用OAC患者的正確治療方法,并根據(jù)整群隨機(jī)PICANT試驗(yàn)的篩查結(jié)果,對(duì)此類(lèi)患者的相關(guān)特點(diǎn)進(jìn)行總結(jié)。方法在德國(guó)黑森州隨機(jī)選取全科診所,由研究成員進(jìn)行到訪研究。使用全科醫(yī)生軟件,以預(yù)先設(shè)定指令生成匿名患者名單,以該匿名名單對(duì)符合條件的患者進(jìn)行調(diào)查。符合條件的患者被分為3組,A組為具有長(zhǎng)期使用OAC指征且正服用抗凝劑的患者;B組為具有長(zhǎng)期使用OAC指征但未服用抗凝劑的患者;C組為不具有長(zhǎng)期服用OAC指征但長(zhǎng)期服用抗凝劑的患者。采用SPSS 20.0軟件進(jìn)行描述性統(tǒng)計(jì)分析。結(jié)果 52家全科診所納入2 036例符合條件的患者,其中,275例患者因無(wú)法歸類(lèi)而被排除。最終納入研究的患者1 761例,其中,A組1 641例,B組78例,C組42例。獲取1 504例患者的國(guó)際標(biāo)準(zhǔn)化比值(INR),其中1 013例患者的INR處在治療區(qū)間。全科醫(yī)生軟件評(píng)估發(fā)現(xiàn),大部分患者具有良好的治療依從性,6.1%的患者服用了新型抗凝劑。結(jié)論大部分患者的抗凝療法正確,應(yīng)長(zhǎng)期使用OAC但未服用抗凝劑的患者和不應(yīng)長(zhǎng)期使用OAC但長(zhǎng)期服用抗凝劑的患者低于預(yù)期,OAC的控制效果在合理高值范圍內(nèi)。
[Abstract]:Objective to treat the complications of thrombus embolism with oral anticoagulant (OAC) combined with coumarin. However, studies have shown that anticoagulant is often overused or insufficient in treatment. In this paper, the correct treatment of patients taking OAC for a long time was discussed, and the related characteristics of these patients were summarized according to the screening results of cluster random PICANT test. Methods the general clinic was randomly selected in Hesse, Germany, and the research members were visited. Use the general practitioner software to generate a list of anonymous patients with predetermined instructions, and use the anonymous list to investigate eligible patients. The eligible patients were divided into three groups: group A (patients with long-term use of OAC indication and taking anticoagulant), group B (patients with long-term use of OAC indication but not anticoagulant) and group C (patients who did not have long-term OAC indication but took anticoagulant for a long time). Descriptive statistical analysis was carried out with SPSS 20.0 software. Results 2036 eligible patients were included in 52 general practice clinics, of which 275 patients were excluded because they could not be classified. Finally, 1761 cases were included in the study, including 1641 cases in group A, 78 cases in group B and 42 cases in group C. The international standardized ratio (INR),) of 1 504 patients was obtained. The INR of 1 013 patients was in the treatment range. General practitioners software evaluation found that most patients had good treatment compliance, 6.1% of patients took new anticoagulant. Conclusion the anticoagulant therapy of most patients is correct. The patients who should use OAC for a long time but not take anticoagulant for a long time and those who should not use OAC for a long time but take anticoagulant for a long time are lower than expected. The control effect of OAC is within a reasonable and high range.
【分類(lèi)號(hào)】：R96

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