Ⅰ类和Ⅱ类切口手术围术期止血药物预防使用分析

Analysis of the preventive use of hemostatic drugs in 589 cases of Ⅰ and Ⅱ type incision in the perioperative period

目的通过调查某三甲医院Ⅰ类和Ⅱ类切口手术患者围术期止血药物预防使用情况,评价止血药物使用的合理性。方法回顾性调查2013年1月至4月Ⅰ类和Ⅱ类切口手术围术期应用止血药物患者589例,分析评价手术类型、止血药物种类、用药时机、使用剂量、用药时间以及药品总费用等。结果 397例Ⅰ类切口、192例Ⅱ类切口止血药物合理使用的比例仅为30.98%和24.48%;蛇毒类血凝酶止血药使用率居前。预防使用止血药物不合理的主要表现形式为:术前未用药术后用药(51.52%)、术后用药时间>3d(18.84%)、单次剂量过大(13.83%)、联合用药不适宜(7.45%)等。结论Ⅰ类和Ⅱ类切口手术围术期应用止血药物存在给药时机不当、用药时间过长、联用率高、用法用量不合理等问题,亟待制订关于止血药物围手术期的应用指导原则,相关部门需加强对围术期止血药物应用规范化管理。

Objective To investigate the preventive use of hemostatic drugs in the 589 cases of typeⅠand Ⅱ incision in the perioper-ative period in clinic ,to evaluate the use rationality ,and to provide the reference and basis for its application .Methods By using the method of retrospective survey ,the cases of typeⅠ and Ⅱ type incision in the hospital during January 2013 to April used he-mostatic drugs to prevent bleeding were analyzed in the aspect of operation types ,kinds ,administration time ,dose of drug ,time of therapy ,expense ,etc .Results The reasonable utilazition rate of cases of type Ⅰ and Ⅱ incision respectively were 30 .98% and 24 .48% ;The utilization ratio of snake venom haemocoagulase was in the top order .Irrational use of hemostatic drugs was mainly in the form of pre-operative administration but not administration after surgery ,time of therapy post-operative medication more than 3 days ,a single overdose of drugs used ,or unreasonable drug combination . The proportion of the rate were 51 .52% , 18 .84% ,13 .83% ,and 7 .45% ,respectively .Conclusion The reasons causing irrational hemostatic drugs use of type Ⅰ and Ⅱincision in the perioperative period were inappropriate administration time ,too long time medication ,or unreasonable drug combi-nation .Therefore ,operative application of guiding principles of the hemostatic drugs in the perioperative period should be devel-oped ,while hospitals need to strengthen the standardized management of the relevant departments .