麻醉性镇痛药使用及依赖性发生的调查

A SURVEY ON UTILIZATION OF NARCOTIC ANALGESICS ANDOCCURRENCE OF DEPENDENCE

本文调查分析１所大型综合性医院１９８９－１９９４年麻醉性镇痛药使用情况，平均年消耗量为２９６４５±ｓ５５９１ＤＤＤｓ。年开支金额逐年增加，１９９４年为１９９０年的４４０％。内科用量占全院的５５．３％，二氢埃托啡片１９９１年猛增至１０万片以上，卫生部下达文件后下降。门诊麻醉镇痛药用量占４．９％，其处方量占总处方量的０．３５％。主要使用单位是急诊科，占７０．２％。男女患者比为２．４：１；２６－４５ａａ组占４５．６％。药物利用指数０．２９－０．７０，使用不当者主要是二氢埃托啡，发现２人发生依赖性。４３名癌痛患者很少按“三阶梯止痛疗法”给药。根据存在的问题，本文提出相应的建议。

Utilization of narcotic analgesics (1989 - 1994) in a general hospitalwas investigated. Average narcotic consumptionper year was 29 645±s 5591 DDDs.The annual expenditure increased gradually and the amount of money expended in 1994was 440% as high as that in 1990. The Department of internal Medicine made up 55. 3%of the total consumption. Dihydroetorphine (DHE) dispensed in 1991 with sharp in-crease to 100 000 tablets, although it decreased after the document of the Ministry ofPublic Health. Prescriptions of narcotics constituted 0. 35% of the total prescriptions inoutpatient clinic, with an energency division accounting for the majority. The numberof male to female patients was in a ratio of 2. 4: 1. It was found that 45. 6% of users were26 - 45 years old. DUI of narcotics was between 0. 27 - 0. 70. Among narcotics DHE wasthe main drug being inproperly used with 2 patients having developed dependence. 43cancer patients were not administered anagelsics on the basis of 'Three - Step AnalgesicLadder' proposed by an expert committee of WHO. Some proposals were made to improve the supply and use of narcotic analgesics.