临床药师在骨科静脉血栓栓塞症预防管理中的药学实践

Pharmaceutical Practice of Clinical Pharmacists in the Prevention and Management of Venous Thromboembolism in Orthopedics

摘要: 目的：提升骨科静脉血栓栓塞症(VTE)高风险患者的药物规范预防实施率。方法：构建以临床药师为主导的多学科协作管理模式，修订医院VTE防治制度，开展医护规范化培训，并派驻临床药师进行全程药学监护与患者教育。以2024年骨科Caprini评分≥5分且出血风险低的患者为对象，进行为期一年的持续质量改进。结果：干预后，VTE高风险患者的药物预防实施率由干预前的约60%显著提升至80%以上，并自2024年7月起持续稳定达标。同时VTE发生率显著下降。结论：临床药师深度参与VTE防治体系，通过提供全程化、精细化的药学服务，能有效提升VTE规范预防率，降低骨科术后患者VTE发生率。该实践模式具有推广价值。

Abstract: Objective: To improve the implementation rate of pharmacologic prophylaxis for orthopedic patients at high risk of Venous Thromboembolism (VTE). Methods: A multidisciplinary collaborative management model led by clinical pharmacists was established. This involved revising the hospital’s VTE prevention and treatment protocol, conducting standardized training for medical staff, and deploying clinical pharmacists to provide comprehensive pharmaceutical care and patient education. A one-year continuous quality improvement project was conducted, targeting orthopedic patients with a Caprini score ≥5 and low bleeding risk in 2024. Results: After the intervention, the pharmacologic prophylaxis implementation rate for high-risk VTE patients increased significantly from approximately 60% before the intervention to over 80%, and has remained consistently above this target since July 2024. Concurrently, the incidence of VTE significantly decreased. Conclusion: The deep involvement of clinical pharmacists in the VTE prevention system, by providing comprehensive and meticulous pharmaceutical services, can effectively improve the rate of standardized VTE prophylaxis and reduce the incidence of VTE in postoperative orthopedic patients. This practical model demonstrates significant value for broader application.