ABSTRACT
OBJECTIVE@#To investigate the role of pharmacist-led anticoagulation monitoring service for warfarin anticoagulation therapy in patients during hospitalization.@*METHODS@#We retrospectively analyzed the data of 421 patients receiving warfarin anticoagulation therapy during hospitalization between April, 2016 and December, 2017. Of these patients, 316 received daily pharmacist-led anticoagulation monitoring service including checking the patients' International Normalized Ratio (INR) and other pertinent laboratory test results and reviewing medication changes and the patients' clinical status (monitoring group); the other 105 patients receiving warfarin anticoagulation therapy without pharmaceutical care served as the control group. The data including compliance rate of anticoagulant indicators, incidence and rate of prompt management of INR alert, thrombosis and bleeding events during hospitalization were analyzed among these patients.@*RESULTS@#Compared with the control patients, the patients in the monitoring group showed a significantly higher percentage time within target INR range [(73.20±9.46)% (46.32±17.11)%, < 0.001] and a higher qualified rate of INR before discharge (98.42% 60.95%, < 0.001) as well as a higher proper INR-monitoring frequency (97.15% 66.67%, < 0.001). The patients in the monitoring group showed a significantly lower incidence of INR alert than the control patients (8.23% 20.00%, < 0.001) with also a much higher rate of prompt management (96.15% 33.33%). The two groups had similar incidences of clinical events except that the control group reported a higher incidence of minor bleeding episodes (9.52% 2.53%, =0.005).@*CONCLUSIONS@#Pharmacist-led anticoagulation monitoring service can significantly improve the effectiveness and safety of warfarin anticoagulation therapy for patients during hospitalization.
Subject(s)
Humans , Anticoagulants , Drug Monitoring , Hospitalization , Pharmacists , Retrospective Studies , WarfarinABSTRACT
Although the surgical techniques has already improved in heart transplantation, heart preservation is still the biggest obstacle to the surgery.At present, heart preservation effective time is only 4-6 hour.How to extent the time of heart preservation is a major research direction.Comparison of available preservations for heart transplantation based on its mechanism and the prospect of its Clinical application.
ABSTRACT
Objective To explore the internal jugular vein liver inside door body bypass surgery (Transjugularintrahepatie portosystemic shunt,TIPS) and part of the spleen embolization (PaniM splenicembolization,PSE) after laparoscopic resection combined with spleen schistosomiasis compounds with cirrhosis of the liver function of spleen hyperthyroidism curative effect.Methods Fifty-two cases had schistosomiasis hepatocirrhosis with spleen function in patients with hyperthyroidism,doing any operation after a week PSE TIPS.Postoperative liver function and adopted to monitor changes,two weeks left hand done help type laparoscopic splenectomy.Results Fifty-two patients underwent TIPS and PSE after surgical treatment,blood picture and liver function back to normal,in two weeks or so do help laparoscopic resection of the hand of the spleen,five cases were transfered to open surgery,patients were cured and discharged.And the previous similar average hospitalization days compared with patients who shorten,average hospital expenses dropped,and less complications,little pain.Conclusion TIPS and PSE joint laparoscopic splenectomy are schistosomiasis compounds with cirrhosis of the liver function of spleen hyperthyroidism,definite effect not only,and safety,minimally invasive,has a good value of clinical application.