中国临床药学杂志2024，Vol.33Issue(9)：667-672,6.DOI:10.19577/j.1007-4406.2024.09.005
低分子肝素预防产褥期静脉血栓栓塞性疾病的药物治疗管理效果
Analysis of effects of low-molecular-weight heparin in the prevention of puerperal venous thromboembolism based on medication therapy management
摘要
Abstract
AIM To explore the efficacy and safety of low-molecular-weight heparin in the prevention of venous thromboembolism(VTE)based on medication therapy management(MTM).METHODS From January 2021 to December 2022,a total of 139 participants were stratified by VTE risk score and randomly divided into 4 groups:medium-risk conventional treatment group(37 patients),medium-risk MTM group(38 patients),high-risk conventional treatment group(31 patients)and high-risk MTM group(33 patients).All results were compared within 4 groups before and after using medication,including coagulation function[activated partial thromboplastin time(APTT),prothrombin time(PT),fibrinogen(FIB),D-dimer(D-D)],platelet(PLT)count,liver and kidney function[alanine aminotransferase(ALT),glutamic oxalacetic transaminase(AST),creatinine(Scr)]and adverse reactions.RESULTS PT and APTT were prolonged in 2 medium-risk groups(P＜0.01)after a day of medication.After a day of medication,the D-D level in the medium-risk MTM group was lower than that in the medium-risk conventional treatment group(P＜0.05).After 7 days of medication,the D-D levels in both the high-risk MTM group and the high-risk conventional treatment group were lower than prior medication.Increased APTT,PLT counts and ALT levels could be observed in 2 high-risk groups after 7 days of medication.AST level was increased in all groups after medication(P＜0.05).At the same time,the level of FIB was decreased(P＜0.05).There was a case of adverse reaction in the medium-risk MTM group.There were 3 cases of adverse reactions in the high-risk MTM group and 7 cases in the high-risk conventional treatment group.The medium-risk MTM group exhibited a lower degree of disease awareness than the high-risk MTM group(P＜0.01).Following the implementation of MTM,an enhancement in medication adherence was observed within the high-risk MTM group(P＜0.01).CONCLUSION Low-molecular-weight heparin can significantly improve the coagulation function during the puerperal period,and its long-term use requires attention to be paid to its effects on liver function and coagulation function.The prevention and treatment level of VTE can be improved by MTM,as well as the disease awareness and medication compliance of parturient women.关键词
低分子肝素/产褥期/静脉血栓栓塞症/药物治疗管理Key words
low-molecular-weight heparin/puerperal period/venous thromboembolism/medication therapy management引用本文复制引用
陈芸萱,周慧,肖春,王朝,周慧民,许厚钦,杨志文..低分子肝素预防产褥期静脉血栓栓塞性疾病的药物治疗管理效果[J].中国临床药学杂志,2024,33(9):667-672,6.基金项目
上海市长宁区医疗卫生科研专项课题(编号CNKW2020Y30) （编号CNKW2020Y30）
