围手术期预防使用质子泵抑制剂合理性分析

Rationality of preventive medication of proton pump inhibitors （PPI） during peri-operative period

目的调查医院围手术期使用质子泵抑制剂（PPI）用药现状，分析质子泵抑制剂预防应激性黏膜病变的合理性。方法依据药品说明书及国内外预防应激性黏膜病变（SRMD）使用质子泵抑制剂的循证指南，调出2013年8—10月份的11—20日6个科室所有围手术期的出院病例474份，进行用药合理性回顾性调查。结果474例患者中预防性使用质子泵抑制剂304例，使用率64．14％。不合理用药病例301例，占99．01％，以无指征用药情况居多，占74．75％，其次是用法用量不合理，占21．26％。结论我院PPI不合理使用情况普遍，应加强PPI使用管理和干预力度，制订标准，改善PPI不合理使用现状，合理、规范使用PPI。

Objective To investigate the situation of preventive medication of proton pump inhibitors （PPI） during peri-operative period at hospital and to analyze the rationality of PPI for preventing stress related mucosal disease （SRMD）. Methods According to the drug instructions and the SRMD at home and abroad of PPI＇s evidence-based guideline, retrospective investigation was conducted on rational use of drugs; 474 cases from 6 departments discharged from 11 to 20 of each month from August to October in 2013 were analyzed. Results Among the 474 cases, PPI was preventively used in 304 cases（64.1%）; of the 304 cases, PPI was irrational used in 301 cases（99.01%）： most without indication （70.31%） and some with unreasonable usage and dosage （20.00%）. Conclusions At our hospital, the irrational use of PPI is universal. Management and intervention should be strengthened, standard set, and PPI use rationalized.