某三甲医院急诊患者中药注射剂使用情况分析

Review of TCM injections used by emergency patients in a 3 A hospital

目的了解和分析某三甲医院急诊患者中药注射剂的使用现状,促进临床合理使用中药注射剂。方法利用临床药学管理系统(PASS),随机抽取2013年1月至2013年6月使用中药注射剂的急诊患者处方,以《卫生部处方点评管理办法(试行)》和《中药注射剂临床使用基本原则》为依据,结合各药品说明书、中药配伍禁忌及中医的辩证施药进行专项点评。结果急诊各科室主要使用中药注射剂有14个品规,使用居前3位的是痰热清、醒脑静、血栓通。总体中药注射剂处方比例为25.6%,总体不合理使用率为39.5%。使用科室共涉及6个急诊科室,不合理率居前3位的依次是急诊骨科(95.9%)、急诊外科(53.0%)、急诊内科(33.2%)。主要不合理用药表现形式有用法用量不适宜、超适应证、溶媒用量不适宜等。结论某三甲医院急诊患者中药注射剂的不合理使用现象较严重,应引起相关部门重视。建议加强临床培训学习,完善HIS功能设置和增强药学人员与临床医生的沟通,促进临床合理使用中药注射剂。

Objective To promote rational drug use by the analysis of the usage of traditional Chinese medicine injection among emergency patients in a 3 A hospital. Methods Using clinical pharmacy management system( PASS),we randomized prescriptions of TCM injections among emergency patients admitted to hospital from January 2013 to June 2013,and conducted a review on the basis of ' The Ministry of Health Prescription Review Management( tentative) ' and ' The Basic Principle of Clinical Use of TCM Injections',drug instruction,incompatibility of TCM and Chinese medicine. Results There were 14 regulations of traditional Chinese medicine injections mainly used in the emergency department,with Tanreqing,Xingnaojing,Xueshuantong as the top three. The overall proportion of traditional Chinese medicine injections prescription was 25. 6%. The overall irrational utilization rate was 39. 5%,involving six emergency departments,with emergency orthopedic( 95. 9%),emergency surgery( 53. 0%),and emergency medicine( 33. 2%) as the top three.The main manifestations of irrational drug use were unfit dosage,ultra indications,inappropriate amount of solvent and so on. Conclusions The irrational use of traditional Chinese medicine injection among the 3A hospital emergency patients is quite serious,which is worthy of attention among relevant departments. It is proposed to strengthen the clinical training,perfect HIS feature set and enhance communication between pharmacy and clinicians,to promote the rational use of traditional Chinese medicine injections.