论文部分内容阅读
目的口服抗凝药物(OAC)联合应用香豆素、新抗凝剂治疗血栓栓塞并发症的效果非常显著。然而,有研究表明,治疗中经常会出现抗凝剂使用过量或用量不足。本文探讨长期服用OAC患者的正确治疗方法,并根据整群随机PICANT试验的筛查结果,对此类患者的相关特点进行总结。方法在德国黑森州随机选取全科诊所,由研究成员进行到访研究。使用全科医生软件,以预先设定指令生成匿名患者名单,以该匿名名单对符合条件的患者进行调查。符合条件的患者被分为3组,A组为具有长期使用OAC指征且正服用抗凝剂的患者;B组为具有长期使用OAC指征但未服用抗凝剂的患者;C组为不具有长期服用OAC指征但长期服用抗凝剂的患者。采用SPSS 20.0软件进行描述性统计分析。结果 52家全科诊所纳入2 036例符合条件的患者,其中,275例患者因无法归类而被排除。最终纳入研究的患者1 761例,其中,A组1 641例,B组78例,C组42例。获取1 504例患者的国际标准化比值(INR),其中1 013例患者的INR处在治疗区间。全科医生软件评估发现,大部分患者具有良好的治疗依从性,6.1%的患者服用了新型抗凝剂。结论大部分患者的抗凝疗法正确,应长期使用OAC但未服用抗凝剂的患者和不应长期使用OAC但长期服用抗凝剂的患者低于预期,OAC的控制效果在合理高值范围内。
Objective Oral anticoagulants (OAC) combined with coumarin, a new anticoagulant in the treatment of thromboembolic complications of the effect is very significant. However, some studies have shown that anticoagulants often occur during the treatment of overdose or under-consumption. This article explores the proper treatment for long-term OAC patients and summarizes the relevant characteristics of these patients based on the results of a randomized PICANT trial. METHODS: A general practice clinic was randomly selected in Hesse, Germany, and study members conducted study visits. Using general practitioner software, a list of anonymous patients is generated with pre-set instructions, and eligible patients are investigated on this anonymous list. Eligible patients were divided into three groups, Group A patients with long-term OAC indications and taking anticoagulants; Group B patients with long-term OAC indications but no anticoagulants; Group C not Patients who have long-term OAC indications but who take anticoagulants on a long-term basis. Descriptive statistical analysis using SPSS 20.0 software. Results A total of 2 036 eligible patients were included in 52 general practice clinics, of which 275 were excluded due to non-categorization. A total of 1 761 patients were enrolled in the study, of which 1641 were in group A, 78 in group B and 42 in group C. International standardization ratios (INRs) were obtained for 1 504 patients, of whom INR was in the treatment interval for 1 013 patients. The GP review found that most patients had good adherence to therapy and 6.1% had new anticoagulants. Conclusions Most patients have anticoagulation therapy that is expected to be lower than expected for patients who have been on OAC for long periods but not on anticoagulants and those who should not be on long-term use of OAC but who take anticoagulants for long periods of time. OAC control is within reasonably high values .