基层医院心房颤动患者华法林抗凝治疗现状分析.docVIP

精品论文 参考文献 基层医院心房颤动患者华法林抗凝治疗现状分析 姜宏伟 王霞 　　[摘 要]目的 对基层医院心房颤动(auricular fibrillation，AF)患者接受华法林(warfarin，WF)抗凝治疗的现状和对AF患者中未使用WF抗凝的因素进行分析和探讨。方法 回顾分析我院2012-06—2015-06资料完整的300例AF住院治疗患者的病历及相关资料，并着重收集AF患者个人的血管栓塞因素、用药禁忌、抗凝药使用情况和未使用WF进行抗凝的临床原因等信息。结果 本研究发现在无抗凝禁忌的302例AF患者中血栓栓塞低危患者160例，其中应用APR抗栓146例，合理应用抗凝药物比率占91.3%；高危患者116例，其中仅24例接受WF抗凝治疗，合理抗凝比率20.7%；未采用WF抗凝的主要原因分别为INR监测不便、患者拒绝、患者依从性差等因素，其所 占 的 构 成 比 率 分 别 为26.8% 、26.8%和24.4%。结论本研究发现，对低危患者人群，APR应用比率较高，除个别患者因存在应用禁忌外，均能及时给予APR抗栓治疗，且剂量合理。但高危人群需应用WF抗凝病例，WF应用不足，反映了对AF患者的抗凝治疗过程中存在着明显的问题。而对WF应用不足原因中，占比率较高的却是患者的主观拒绝和担心、INR监测的不便及依从性差，今后工作中应进一步加强宣教沟通，提高AF抗凝合理用药。 　　[关键词] AF APR WF 抗凝 应用 　　DOI:10.3760/cma.j.issn.0376-2491.2015.32.09 　　作者单位：265600，山东蓬莱，蓬莱市人民医院 　　Analysis of the Situation of Warfarin Anticoagulation Therapy in Patients with Atrial Fibrillation in Grass-root Hospitals 　　Jiang Hongwei, Wang Xia 　　Abstract: Objective To analyze the situation of (auricular fibrillation, AF) patients accepting warfarin (warfarin, WF) anticoagulant therapy and to explore the reasons of AF patientsrsquo; not accepting WF therapy in grass-roots hospital. Method The medical records and related data of 300 cases of AF hospitalization patients from the authorsrsquo; hospital from June 2012 to June 2015 were retrospectively analyzed. Attention was focused on the collecting of AF patientsrsquo; personal vascular embolism factors, contraindications, anticoagulants and the clinical reasons of AF patients who have not used WF anticoagulant. Result This research indicate that in all the 302 cases without contraindications to anticoagulants, there were 160 thromboembolism low-risk cases, 146 cases of whom took APR antithrombotic, with the rational use of anticoagulant ratio of 91.3%; among the 116 cases of high-risk patients, only 24 cases accepted WF anticoagulant therapy, with the reasonable anticoagulant ratio of 20.7%; the main reasons of not adopting WF anticoagulation are INR monitoring inconvenience, patient refusal, patient poor complia