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[基层医疗中口服抗凝治疗随访的治疗质量控制:4年经验]

[Therapeutic quality control of follow-up of oral anticoagulation in primary care: 4-year experience].

作者信息

Alonso Roca R, Puche López N, de la Fuente Arriarán M D, Serrano Santos P, García Monterrubio L

机构信息

Centro de Salud Isabel II de Parla, Madrid.

出版信息

Aten Primaria. 1995 May 31;15(9):555-60.

PMID:7612787
Abstract

OBJECTIVE

To find the rate of therapeutic control and the frequency of complications among patients receiving oral anticoagulant therapy, attending in a primary care center.

DESIGN

Descriptive study over the last four years.

SETTING

An urban primary care center.

PATIENTS AND METHODS

We included all patients in oral anticoagulant treatment controlled in our center among 1989 and 1993, excluding that patients with less than three months in control, or discontinued control. The prothrombin time was measured by international normalized ratio (INR). To measure the therapeutic quality control, we used the method proposed by the International Society of Thrombosis and Haemostasis. The frequency of complications was measured in number of events/100 patients/year.

RESULTS

In the 136 patients studied the average time in control was 23.57 months. The 68.37 percent of determinations were within satisfactory ranges. The frequency of minor hemorrhages was 13.36 by 100 patients/year, 1.08 of major hemorrhages, and 2.53 of thromboembolism events.

CONCLUSIONS

The results obtained in this audit are similar to the communicated by other centers. The therapeutic control of oral anticoagulants can carry out in primary care with enough quality and some advantages: more facility to health education, better accessibility, and more integration of anticoagulation therapy in global care of patients.

摘要

目的

在一家初级保健中心,找出接受口服抗凝治疗患者的治疗控制率及并发症发生率。

设计

对过去四年的描述性研究。

地点

一个城市初级保健中心。

患者与方法

我们纳入了1989年至1993年在本中心接受口服抗凝治疗且病情得到控制的所有患者,排除控制时间少于三个月或已停止控制的患者。通过国际标准化比值(INR)来测定凝血酶原时间。为衡量治疗质量控制,我们采用了国际血栓与止血协会提出的方法。并发症发生率按事件数/100患者/年进行测定。

结果

在研究的136例患者中,平均控制时间为23.57个月。68.37%的测定结果在满意范围内。轻微出血发生率为13.36/100患者/年,严重出血发生率为1.08/100患者/年,血栓栓塞事件发生率为2.53/100患者/年。

结论

本次审计得出的结果与其他中心公布的结果相似。口服抗凝剂的治疗控制可在初级保健中以足够的质量进行,并且具有一些优势:健康教育更便利、可及性更好以及抗凝治疗在患者整体护理中融合度更高。

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