临床医生对醒脑静注射液临床应用的认知与行为调查

Knowledge,attitude and practice of clinical physicians on use of Xing Nao Jing injection

目的了解临床医生对醒脑静注射液合理使用的认知和行为,为促进醒脑静合理使用提供依据。方法根据之前研究的结果,制订调查问卷,对20家医疗机构的353名医生进行问卷调查,了解对于醒脑静适应证、应用指征、用法用量、应用时机、合并用药等方面的认知与实践。对调查结果进行统计分析。结果各说明书适应证均有一定比例的医生未选择其作为醒脑静的用药适应证,其中未选择肝昏迷的比例最高,为38.7%。38.7%问卷中选择了非说明书适应证。多数医生认为醒脑静应用于病情较重或存在意识障碍的患者。醒脑静应在发病后早期使用,单次剂量为20～40mL,疗程不宜过长或应在急性期使用。醒脑静不应和清开灵注射液及生脉注射液合用。结论对于醒脑静的临床应用,多数医生的认知和实践符合药品说明书及现有循证医学证据,少数医生持不同观点,可能和醒脑静的不合理使用相关。

Objective To investigate the knowledge, attitude and practice of clinical physicians on use of Xing Nao Jing In- jection （in abbreviation XNJ） , and to provide base for the rational use of XNJ. Methods A questionnaire was developed according to the previous study. 353 Doctors from 20 hospitals were surveyed. The knowledge and prescribing practices related to XNJ such as indication, dosage, course, etc. were inquired. Results Each li- censed indication of XNJ has some doctors who did not chosen it as suitable indication, and the ratio was from 9.9% for cerebral hemorrhage to 38.7% for hepatic coma. 38.7% of the doctors also choose non-licensed indica- tions as suitable indications. Most of the doctors choose that XNJ should be used in serious cases or those with conscious disturbance. XNJ should be used in early phase of the disease course. Single dose of XNJ should be 20~40ml and the treatment duration should be less the 14 days. XNJ should not combine with Qing Kai Ling and Sheng Mai injection, which are also injection of traditional Chinese herbs. Conclusion The knowledge and practice of most doctors on XNJ were complied with the licensed medication instruction and present clinical evidence. The deviations from the licensed medication instruction and present clinical evidence may contribute to the irrational use of XNJ.