我院2013年9-12月心血管外科手术患者预防使用质子泵抑制剂点评

Analysis and Comment of Prophylactic Application of Proton Pump Inhibitor in Cardiovascular Surgery Patients of Our Hospital during Sept.-Dec.in 2013

目的:为干预措施制订提供数据支持,促进临床合理用药。方法:选择2013年9-12月福建省立医院心血管外科出院的手术患者,设计心血管外科手术患者预防使用质子泵抑制剂(PPIs)点评表,收集患者基本信息、住院天数、临床诊断、手术信息及PPIs使用情况,参照《应激性溃疡防治建议》及药品说明书对PPIs使用情况进行专项点评。结果:总共点评229份病历,其中187份使用了PPIs,使用率为81.7%,泮托拉唑的使用频次最高;专项点评结果显示,疗程过长是最常见的不合理用药表现,另外还存在用药频次错误、无指征更换药物、明显药物相互作用、重复用药、无适应证用药及溶剂选择错误等不合理现象。结论:此次专项点评发现PPIs在临床使用过程中存在诸多不足,将根据点评结果制订行政及技术干预措施,并持续改进,促进PPIs的合理使用。

OBJECTIVE：To provide evidence supporting for the formulation of the interventions and promote the rational use of drug. METHODS：Patient discharged from cardiovascular surgery department of Fujian Provincial Hospital between Sept.and Dec. in 2013 were chosen;comment Form on Prophylactic Application of PPIs in Cardiovascular surgery Patients was designed;comment criteria were set according to Stress Ulcer Prevention and Treatment Suggestion and package insert;the application of PPIs was evaluated. RESULTS：A total of 229 cases were commented,of which 187 cases（81.7%）used PPIs;among all of PPIs,pantoprazole was most frequently used. Results of specialized comment showed that the most common irrational drug use was excessive long duration;there were other irrational drug use phenomena,such as medication frequency errors,non-indications drug replacement,significant interactions,repeated medication,non-indications medication,solvent selection error,etc. CONCLUSIONS：The study finds some irrational use of PPIs. Our hospital develops administrative and technology intervention measures according to comment result,and continuously improves rational drug use.