Đánh giá sử dụng thuốc trên bệnh nhân rung nhĩ không do bệnh lý van tim điều trị tại Trung tâm Tim mạch, Bệnh viện Hữu nghị Đa khoa Nghệ An

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Thị Soa Đặng, Thị Ánh Hắc, Thị Thùy Dương Hoàng, Huy Lợi Nguyễn, Ngọc Hòa Nguyễn

Ngôn ngữ: vie

Ký hiệu phân loại: 543.4 Electrochemical analysis

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2022

Mô tả vật lý: 332-337

Bộ sưu tập: Metadata

ID: 499302

Thêm vào giỏ

Khảo sát sử dụng thuốc điều trị trên bệnh nhân rung nhĩ và phân tích tính hợp lý trong sử dụng thuốc điều trị cho bệnh nhân rung nhĩ không do bệnh lý van tim tại Bệnh viện Hữu nghị Đa khoa Nghệ An. Đối tượng và phương pháp nghiên cứu: Mô tả cắt ngang 64 hồ sơ bệnh án bệnh nhân rung nhĩ không do bệnh lý van tim điều trị tại Trung tâm Tim mạch Bệnh viện Hữu nghị Đa khoa Nghệ An. Kết quả: Tuổi trung bình 66,63 ± 13,94
nam/nữ = 1,4
bệnh lý mắc kèm: 70,3% tăng huyết áp
40,6% suy tim
17,2% có đái tháo đường
12,5% suy thận
7,8% COPD. 43,8% nguy cơ đột quỵ cao theo thang điểm CHA2DS2- VASc. Yếu tố nguy cơ đột quỵ gặp nhiều nhất là tăng huyết áp (70,3%)
suy tim (40,6%), tuổi >
75 (18,8%)
hút thuốc là (15,6%), tiền sử đột quỵ/thoáng thiếu máu não (12,5%)
Chủ yếu là dùng chống đông kháng vitamin K trong đó acenocoumarol (54,7%), warfarin (3,1%), enoxaparin (35,9%). Nhóm chống kết tập tiểu cầu (aspirin 26,6%
clopidogrel (14,1%). Chẹn β (metoprolol 35,9%
bisoprolol 31,3%)
31,7% dùng digoxin
1 trường hợp dùng amiodaron. Thuốc UCMC 62,5%
CKCa - DHP 9,4%. 95,3,3% bệnh nhân trong mẫu nghiên cứu được chỉ định thuốc dự phòng huyết khối phù hợp. 4,7 % không phù hợp, trong đó có 01 trường hợp chỉ định chống đông trên bệnh nhân nguy cơ đột quỵ thấp theo thang điểm CHA2DS2-VASC (26,7%)
có 1 trường hợp nguy cơ đột quỵ cao nhưng không chỉ định sử dụng chống đông
1 trường hợp chỉ định ức chế kết tập tiểu cầu trên đối tượng nguy cơ đột qụy cao. 95,3% lựa chọn thuốc kiểm soát tần số thất phù hợp. Có 3 trường hợp chưa phù hợp, nguyên nhân là bệnh nhân COPD ưu tiên Chẹn Beta (4,7%). 100% liều dùng các thuốc trong nghiên cứu được sử dụng phù hợp. Kết luận: Thuốc chống đông chủ yếu dùng kháng vitamin K, phần lớn được chỉ định dự phòng huyết khối, kiểm soát tần số thất phù hợp với hướng dẫn của Bộ Y tế trong điều trị rung nhĩ.To survey the use of drugs for treatment of patients with atrial fibrillation and to analyze the rationality of drug use in patients with non-valvular atrial fibrillation at Cardiovascular Center of Nghe An Friendship General Hospital. Subjects and research methods: A cross-sectional description of 64 medical records of patients with nonvalvular atrial fibrillation treated at the Cardiovascular Center of Nghe An General Hospital. Results: Mean age 66.63 ± 13.94
male/female = 1.4
comorbidities: 70.3% hypertension
40, 6% heart failure
17.2% have diabetes
12.5% renal failure
7.8% COPD. 43.8% high risk of stroke according to the CHA2DS2-VASc score. The most common stroke risk factor is high blood pressure (70.3%)
heart failure (40.6%), age >
75 (18.8%)
smoking (15.6%), history of stroke/transient ischemic attack (12.5%)
Mainly used anticoagulant vitamin K, including acenocoumarol (54.7%), warfarin (3.1%), enoxaparin (35.9%). Antiplatelet group (aspirin 26.6%
clopidogrel (14.1%), β-blocker (metoprolol 35.9%
bisoprolol 31.3%)
31.7% used digoxin
1 case used amiodarone
ACEi 62.5%
CKCa - DHP 9.4%. 95.3% of patients in the study sample were prescribed appropriate thromboprophylaxis. 4.7% were not suitable, in which there was 1 case of anticoagulation in patients with low stroke risk according to the CHA2DS2-VASC scale (26.7%)
there was 1 case of high stroke risk but no anticoagulation was indicated
1 case indicated platelet aggregation inhibitors in subjects at high risk of stroke. 95.3% choose appropriate ventricular rate control drugs. There were 3 unsuitable cases, the unsuitable cause was in COPD patients with priority Beta Blocker (4.7%). 100% of the doses of the drugs in the study were used appropriately. Conclusion: Anticoagulants are mainly used vitamin K antagonists, mostly indicated for thromboprophylaxis, control of ventricular rate in accordance with the guidelines of the Ministry of Health on clinical pharmacological practice in the treatment of atrial fibrillation.

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