药师参与下的标本评估对万古霉素血药浓度解读的改善性研究

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万方数据
维普

中文摘要：目的评价由药师参与下的血液标本质量评估对万古霉素血药浓度解读的影响.方法回顾性收集2022年1月—12月在武汉市第一医院使用万古霉素抗感染治疗并监测血药浓度的患者资料.以不合格标本分布类型及占比、科室分布、再评估不合格标本复查前后结果差值、血药浓度分布等作为观察指标.结果共纳入92例患者,177个血液标本,涉及20个科室,最终进入谷浓度监测环节的有162个.59个(36.42％)标本合格且浓度达窗(10～20 mg/L),浓度不足10 mg/L占22.84％(37/162个),高于20 mg/L占30.86％(50/162个).合格标本共115个(64.97％).不合格标本共62个(占35.03％),初评估不合格15个(8.47％),再评估不合格47个(26.55％).对再评估不合格的标本在规范宣教后进行复测,其中有44个前后浓度结果具有显著差异(P＜0.05),其中"给药后采血"的情况,复测前后差值最大(-16.5 mg/L).结论以标本为中心的管理模式下,在分析前和分析后分别对标本做合理评估,使得万古霉素TDM数据的可靠性大大提升,临床应用价值得到充分发挥.

外文标题：Study on the improvement of the interpretation of plasma vancomycin concentration through sample evaluation with the participation of pharmacists

外文摘要：Objective To evaluate the impact of blood sample quality assessment with the participation of pharmacists on the interpretation of vancomycin(VAN)plasma concentration.Methods A retrospective data on the patients treated with VAN and monitored on their plasma concentration was collected in Wuhan No.1 hospital from January to December,2022.The observation indexes,such as distribution type and proportion of unqualified samples,department distribution,difference between the before and the after of the re-evaluation of unqualified samples,and VAN plasma concentration distribution,were investigated.Results The study involved 92 patients and 177 samples from 20 related departments,with a total of 162 samples entering the VAN plasma concentration monitoring process.The proportion of qualified samples within the therapeutic concentration window of 10～20 mg/L was about 36.42％(59/162),being 22.84％(37/162)below 10 mg/L,and 30.86％(50/162)over 20 mg/L.The qualified samples were altogether 115(64.97％).The total unqualified samples were 62(35.03％),of which 15 were from the initial evaluation and 47 were from the re-evaluation.The unqualified samples from the re-evaluation were retested after standardized propaganda and education.The total 44 of samples indicated a significant concentration difference between the before and after of the retesting(P＜0.05),wherein,the samples from blood collection after administration exhibited the largest difference value(about-16.5 mg/L).Conclusion Under the sample-centered management mode,a significant improvement on the reliability of VAN TDM data has been achieved through reasonable evaluation in the pre-and post-analytical process,thus indicating a clinical application.

外文关键词：

Sample evaluationVancomycinSample-centeredInterpretation of plasma vancomycin concentrationIndividualizing pharmaceutical care

作者：

刘剑敏、宋维、黄蕾、邓体瑛

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作者单位：

武汉市第一医院药学部,武汉 430022

关键词：

标本评估万古霉素以标本为中心血药浓度解读个体化药学服务

基金：

"十二五"中医药重点学科临床中药学建设项目湖北省临床药学重点专科深圳市叶澄海慈善基金会

项目编号：

国中医药人教发[2012]32号鄂卫通[2019]125号2023LCYXGZMS5-2

出版年：

2024

中国抗生素杂志

中国医药集团总公司四川抗菌素工业研究所,中国医学科学院医药生物技术研究所

中国抗生素杂志

CSTPCD北大核心

影响因子：1.08

ISSN：1001-8689

年,卷(期)：2024.49(9)