奥沙利铂处方合理性及安全性分析

Rationality and Safety of Oxaliplatin Prescription

目的回顾性调查评价我院奥沙利铂临床应用合理性。方法利用医院信息系统（HIS）,随机抽取2014年4月1日~2015年3月31日我院使用奥沙利铂病例,分析其临床使用的合理性及安全性。结果调查的1年当中,全院使用奥沙利铂共计531例,随机抽取120例进行分析。其中,适应证与说明书相符的为55例（45.83%）,65例（54.17%）为超说明书用药,均符合指南推荐;6例（5%）为给药频次不规范,3例（2.5%）为给药剂量不适宜;64例出现不良反应,主要累及消化系统30例（25.00%）、造血系统46例（38.33%）和神经系统13例（10.83%）,还出现静脉炎1例,皮疹1例。结论奥沙利铂在临床应用中存在超说明书用药情况。医院应加强抗肿瘤药物超说明书应用的管理,做好实时跟踪和信息反馈,促进临床合理用药。

Objective To evaluate rationality of the clinical use of oxaliplatin in our hospital. Methods Using the hospital information system, we collected cases of oxaliplatin from April 2014 to March 2015, and analyzed the rationality and safety. Results The cases of oxaliplatin were 531 in total. 120 cases were randomly selected for analysis. Indications were consistent with the drug instructions in 55 cases （45.83%）. 65 cases （54.17%） off-label use, but consistent with the guidelines recommendation. Improper dosing frequency for 6 cases （5%） and improper dosage of administration for 3 cases （2.5%） were observed. 64 cases had adverse reactions, mainly involving the digestive system for 30 cases （25.00%）, hematopoietic system for 46 cases （38.33%） and the nervous system for 13 cases （10.83%）. There also were one case of phlebitis and one case of skin rash. Conclusion Off-label use of oxaliplatin is common in our hospital, most of which is evidence-based. It is urgent to strengthen the management of antineoplastic drugs,conduct real-time tracking and information feedback, and promote rational drug use.