【摘要】 目的：探索急性肺栓塞患者住院药学监护模式，规范抗凝血药的合理应用。方法：选取2020年10月至2021年7月郑州大学附属郑州中心医院收治的急性肺栓塞患者为研究对象。其中，2020年10月至2021年5月的患者未进行抗凝血药住院药学监护管理，评价抗凝治疗方案存在的问题，采用柏拉图法明确影响抗凝治疗合理性的主要因素，建立《急性肺栓塞患者抗凝治疗住院药学监护模式》;2021年6—7月的患者按照该模式进行用药监护，并比较该模式建立前后患者抗凝治疗的合理性，规范急性肺栓塞患者抗凝血药的合理应用。结果：抗凝血药用法与用量不适宜、未进行有效重叠治疗和重复用药为影响其合理应用的主要因素。住院药学监护模式实施后，急性肺栓塞患者抗凝血药治疗合理率由实施前的61.73%(50/81)升至90.48%(19/21),差异有统计学意义(P<0.05)。结论：按照《急性肺栓塞患者抗凝治疗住院药学监护模式》对急性肺栓塞患者进行规范化管理，可显著提高抗凝血药应用合理性。更多还原

【Abstract】 OBJECTIVE: To explore the mode of inpatient pharmaceutical care for patients with acute pulmonary embolism and standardize the rational application of anticoagulant drugs. METHODS: Patients with acute pulmonary embolism admitted into Zhengzhou Central Hospital Affiliated to Zhengzhou University from Oct. 2020 to Jul. 2021 were selected as the subjects. Among them, patients from Oct. 2020 to May 2021 did not receive inpatient pharmaceutical care mode for anticoagulation therapy. The problems of anticoagulation regimens were evaluated, the main factors affecting the rationality of anticoagulation therapy were clarified by using the Plato method, and the Inpatient Pharmaceutical Care Mode for Anticoagulation Therapy in Patients with Acute Pulmonary Embolism was established. Patients from Jun. to Jul. 2021 were monitored according to the mode, and the rationality of anticoagulation therapy before and after the establishment of the mode was compared to standardize the rational application of anticoagulant drugs in patients with acute pulmonary embolism. RESULTS: Inappropriate drug usage and dosage, no effective overlap treatment, and repeated medication were the main factors affecting the rational application of anticoagulant drugs. After implementation of inpatient pharmaceutical care mode, the rational rate of anticoagulation therapy in patients with acute pulmonary embolism increased from 61.73%(50/81) before implementation to 90.48%(19/21), the difference was statistically significant(P<0.05). CONCLUSIONS: According to the Inpatient Pharmaceutical Care Mode for Anticoagulation Therapy in Patients with Acute Pulmonary Embolism, standardized management of patients with acute pulmonary embolism can be performed, which can significantly improve the rationality of application of anticoagulant drugs.更多还原