门诊新近合并用药对长期使用华法林患者的凝血功能影响相关药学服务

目的：观察长期使用华法林患者由于新近合并出现的临床状况而合并用药情况对凝血功能的影响,并讨论药学服务方案,减少华法林抗凝治疗的并发症。方法：调查统计我院2006年1月~2009年12月门诊长期使用华法林抗凝患者178例,入选由于新近合并出现其他临床状况而临时新增合并用药者进行分析,比较合并用药3天及7天后患者凝血功能的改变,并入选没有新近新增合并用药患者作为对照。结果：门诊新增合并用药7天后可使长期使用华法林患者的凝血功能改变发生率明显增加,与对照组相比具有显著统计学意义（p〈0.05）。结论：即使门诊短期合并其他药物治疗,对患者的凝血功能也存在不可忽视的影响,临床药师应积极开展合理有效的药学服务,提高临床医师及患者对凝血功能监测的重视,减少减少华法林抗凝治疗中出血和血栓等并发症的发生。

The Effects of Newly Combined Medicine on The INR of Outpatient Warfarin User and Related Pharmaceutical Services

OBJECTIVE： The purpose of the present study was to evaluate the effects of newly combined medicine on the INR of outpatient warfarin users.And discuss the pharmaceutical services to reduce the complication of warfarin.METHODS： 178 out patients with long-term warfarin therapy were include and devided into two groups.Group A was the patients with newly combined medicine because of other clinical status.Group B was the patients with none newly combined medicine.The basic INR when included and the INR 3days and 7 days later was tested.RESULTS： Newly combined medicine for 7 days can affect the INR obviously in the long-term warfarin users.CONCLUSION： Even for short-term combination therapy,newly combined medicine can affect the anticoagulation effects of warfarin obviously.Clinical pharmacist should evolve pharmaceutical services to raise the attention of clinicist and patients for INR monitoring,and reduce the complication of warfarin.