OBJECTIVE:To investigate the application status of antithrombotics for patients with atrial fibrillation during perioperative period , so as to provide reference for the improvement of safety and rationality of antithrombus therapy during perioperative period .METHODS:64 inpatients with atrial fibrillation undergoing surgical operation admitted in the First People's Hospital of Nangtong from Jan.2016 to Jun.2017 were extracted as the research objects , retrospective analysis was conducted on patients ' basic information , withdraw and reuse of atrial fibrillation during perioperative period , bridging anticoagulation, INR monitoring and adverse drug reactions , etc.RESULTS: The average duration of preoperative discontinuation of warfarin, aspirin, aspirin and clopidogrel were relatively short , respectively (1.80 ±1.90),(2.70 ±2.80) and (2.50 ±2.60) days.As far as the time of reusing antithrombotics , except for rivaroxaban whose time was too long [(5.50 ±4.30)days], other drugs was in accordance with the guidelines .The rate of bridging anticoagulation was 60.9％(14/23).In terms of patients with warfarin, the INR monitoring rates of before and after surgery were 57.6％(19/33) and 73.1％( 19/26 ) . The incidence of adverse drug reactions during perioperative period was 3.13％ ( 2/64 ) . CONCLUSIONS: The time interval of withdraw of antithrombotics was short and the experience of the new oral anticoagulant like rivaroxaban was insufficient .The bridging anticoagulation and the INR monitoring rate were still need to be further improved .Therefore , the clinical pharmacists should strengthen the pharmacy services to help the physicians to develop individualized dosing programs , so as to reduce the incidence of adverse drug reactions .%目的:了解心房颤动住院患者围术期抗血栓药应用现状,为提高围术期抗栓治疗的安全性、合理性提供参考.方法:以2016年1月—2017年6月南通市第一人民医院行外科手术或操作的心房颤动住院患者64例为研究对象,对患者的基本信息、围术期抗血栓药的停用及重启情况、桥联抗凝、INR监测及不良反应等情况进行回顾性分析.结果:64例患者使用华法林、阿司匹林和阿司匹林分别与氯吡格雷联合抗血小板治疗的平均术前停药时间间隔偏短,分别为(1.80±1.90)、(2.70±2.80)和(2.50±2.60)d;术后重启抗血栓药时间方面,除利伐沙班偏长外[(5.50±4.30)d],其余药物均符合相关指南规定;桥联抗凝率为60.9％(14/23);服用华法林者,术前、术后国际标准化比值监测率分别为57.6％(19/33)、73.1％(19/26);围术期不良反应发生率为3.13％(2/64).结论:术前抗血栓药停服时间间隔偏短,新型口服抗凝血药(利伐沙班)使用经验不足,桥联抗凝及国际标准化比值监测率还有待进一步提高.对此,临床药师应加强药学服务,协助医师制订个体化给药方案,减少不良反应的发生.
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