某三甲医院住院消化道肿瘤患者抗凝预防现状调查与分析

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摘要目的回顾性调查与分析住院消化道肿瘤患者抗凝预防现状，探讨临床药师在住院消化道肿瘤患者静脉血栓栓塞症（VTE）预防中发挥的作用。方法应用随机数字表法抽取上海某三甲医院2019年7月至12月住院的消化道肿瘤患者120例，对患者进行静脉血栓风险评估，并对患者抗凝药物使用情况进行回顾性调查与分析。结果外科手术患者应用Caprini评分量表46例；肿瘤化疗患者应用Khorana评分量表，共41例；内科住院患者应用Padua评分量表，共33例。120例患者中，19例选择那曲肝素或利伐沙班进行预防性抗凝。根据Caprini评分得出≥3分高危肿瘤患者45例，其中给予预防抗凝17例；Khorana评分≥1分中高危患者41例，无预防抗凝患者；Padua评分≥4分中高危患者13例，预防抗凝1例。结论该院消化道肿瘤患者总体预防抗凝比例较低，临床药师要加强对临床科室肿瘤相关VTE的宣教工作，提高临床医师预防抗凝意识，降低恶性消化道肿瘤患者VTE发病率并提高其生存率。

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	陶婕妤程学芳李琴周琰

关键词 ：消化道肿瘤, 静脉血栓栓塞症, 抗凝, 预防, 临床药师

Abstract：Objective To retrospectively investigate and analyze the current status of anticoagulant prevention in hospitalized patients with gastrointestinal tumors, and to explore the role that clinical pharmacists played in the prevention of venous thromboembolism (VTE) in hospitalized patients with gastrointestinal tumors. Methods A random number table was used to select 120 patients with gastrointestinal tumors hospitalized in a tertiary hospital in Shanghai from July to December 2019, the risk of venous thrombosis was evaluated, and the use of anticoagulant drugs in the patients were retrospectively investigated and analyzed. Results The Caprini score scale was used in 46 cases for surgical patients; the Khorana score scale was used for cancer chemotherapy patients, a total of 41 cases; and the Padua score scale was used for medical inpatients, a total of 33 cases. Among 120 patients, Nadroparin or Rivaroxaban for preventive anticoagulation was chosen by 19 cases. According to the Caprini score, 45 patients with high-risk tumors ≥3 points were obtained, of which 17 were given preventive anticoagulation; 41 patients with Khorana score ≥1 point were medium-high-risk patients, and there were no patients with preventive anticoagulation; there were 13 high-risk patients with Padua score ≥4 points, and 1 case of preventive anticoagulation. Conclusion The overall rate of anticoagulation prevention for patients with gastrointestinal tumors in the hospital is relatively low. Clinical pharmacists should strengthen the education of tumor-related VTE in clinical departments, improve clinicians’ awareness of preventing anticoagulation, reduce the incidence of VTE in patients with malignant gastrointestinal tumors and improve their survival rate.

Key words： Gastrointestinal cancer Venous thromboembolism Anticoagulation Prevention Clinical pharmacists

基金资助:国家自然科学基金资助项目（81603083）；
上海市卫生健康委员会临床专项课题（20204Y0462）；
上海市“医苑新星”青年医学人才培养资助计划-临床药师项目（沪卫人事〔2021〕99号）。

通讯作者: 周琰（1987.11-），女，博士，主要从事临床药学研究。

引用本文:

陶婕妤程学芳李琴周琰. 某三甲医院住院消化道肿瘤患者抗凝预防现状调查与分析[J]. 中国医药导报, 2021, 18(35): 63-67.
TAO Jieyu CHENG Xuefang LI Qin ZHOU Yan. Investigation and analysis of the current status of anticoagulation prevention for inpatients with gastrointestinal tumors in a tertiary hospital#br#. 中国医药导报, 2021, 18(35): 63-67.

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https://www.yiyaodaobao.com.cn/CN/ 或 https://www.yiyaodaobao.com.cn/CN/Y2021/V18/I35/63

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