某三甲医院肿瘤患者严重药物不良反应分析

Analysis of Serious Adverse Drug Reactions of Cancer Patients of A Grade-A, Class-3 Hospital

目的：对肿瘤患者严重不良反应的特点、相关因素进行分析,为指导临床安全用药提供参考。方法：采用回顾性分类统计,对某三甲医院药品不良反应监测中心2004-2013年收集的肿瘤患者严重药品不良反应报告进行综合分析。结果：268例严重ADR报告中,新的有23例（8.58%）;50~59岁年龄段58例（21.60%）比例最高;白血病患者最多,其次为肺癌、胃癌患者;ADR累及系统或器官及临床表现以血液系统（42.86%）居首,其中以骨髓抑制最为多见;化疗科呈报的报告最多;151份报告联合用药,并以二联用药最多;报告共涉及药品106种455例,以顺铂41例位居第一;用药途径以静脉滴注为主;所有药品中抗肿瘤药物最多,共51种372例（81.72%）,抗代谢药占的比例（37.74%）最大。结论：应加强肿瘤患者严重不良反应的监测,以便根据肿瘤患者的自身特点,有目的性地进行合理给药。

Objective：Guiding rational and individualized dosing and providing ideas for designing best drug to specific populations by analyzing the features and related factors of serious adverse drug reactions（ADR） in tumor patients. Method： Comprehensively analyzing serious ADR cases induced by tumor patients in Adverse Reaction Monitoring Center of a Grade-A, Class-3 hospital from January 2004 to December 2013, with method of retrospective classified statistics.Results：There are 23 new cases（8.58%） in 268 cases of serious ADR reports, and the age group of 50 ~ 59 years old occupies 58 cases（21.60%）, which is of the highest percentage; Leukemia patients are the largest population among all the patients, followed by lung cancer and gastric cancer patients; most ADR cases involved the blood system（42.86%）, in which the myelosupression is the most common; most reports are from chemotherapy department; 151 reports are combination therapy, and the most common usage is combination of two drugs; 455 cases involving 106 kinds of drugs in all reports, in which cisplatin places the first with its 41 cases; route of administration was mostly intravenous infusion; Antineoplastic drugs are the most, which is of totally 51 kinds of 372 cases（81.72%） among all drugs involved; Anti-metabolite occupies 37.74% percentage achieving the maximum. Conclusion：The method of monitoring the relevance of ADR occurrence should be strengthened, so as to achieve reasonable medication and individual therapy following the characteristics of the tumor patients.