某院急诊注射用质子泵抑制剂的临床应用分析

Analysis of clinical application of proton pump inhibitor for injection in emergency patients

目的:对某院急诊注射用质子泵抑制剂(PPIs)的使用情况进行分析,为临床合理用药提供参考。方法:采用回顾性调查研究的方法,检索某院HIS,获取2015年7月份使用过注射用PPIs的急诊患者处方,依据SAHP(美国医院药师协会)指南及药品说明书对其临床应用进行合理性分析。结果:在1 754份处方中,统计结果显示某院急诊使用PPIs注射剂的临床诊断不符合使用指征占比24.7%,用法用量不合理的处方占比7.5%,联合用药不合理占比为1.7%,老年患者使用潘妥洛克日剂量超40 mg一项为5.4%,具有统计学意义,其合理性有待进一步讨论研究。结论:某院急诊科使用注射用质子泵抑制剂存在不合理现象。为减轻患者经济负担及降低用药风险,临床医生应规范诊疗行为,做到诊断与用药相适应,杜绝无正当理由超适应证用药;可通过处方点评或信息系统引导用药等干预措施来改善目前的用药现状。

OBJECTIVE To analyze use of proton pump inhibitors （PPIs） for injection in emergency and provide a reference for clinical rational drug use. METHODS Through HIS, patients received PPIs injection in emergency in July 2015 were select- ed. Prescriptions were retrospectively analyzed according to ASHP therapeutic guidelines and patient information leaflets. RE- SULTS A total of I 754 PPIs prescriptions in the emergency were included. Common prescribing errors： clinical diagnosis did not supported use of PPIs （24. 7%）, wrong dosage and usage （7. 5%）, irrational ratio of combined medication （1.7%）. Old patients used Pantoloc more than 40mg, which accounted for 5.4% of medication error. It was statistically significant, and the rationality needed to be further discussed. CONCLUSION Part of PPIs use in emergency department is irrational. To reduce e- conomic burden and lower risk of medication, clinical physicians should standardize clinical diagnosis and therapy, make diagno-sis and medication consistent, avoid irrational off-label drug rise. Intervening measures including prescription comment and in- formation system guided medication can be used to improve current situations.