3005例住院患者质子泵抑制剂应用调查与分析

Investigation and Analysis on Application of Proton Pump Inhibitors on 3005 Inpatients

目的:了解广东省中医院(以下简称"该院")住院患者质子泵抑制剂的使用情况,以促进质子泵抑制剂的合理应用。方法:查阅相关指南、文献、药品说明书等资料,制定质子泵抑制剂临床应用评价标准;随机抽取2015—2016年该院3 005例使用质子泵抑制剂住院患者的病历资料,对质子泵抑制剂的使用情况进行评价与分析;采用二元Logistic回归分析质子泵抑制剂应用趋势的影响因素。结果:3 005例使用质子泵抑制剂的住院患者中,静脉给药1 352例(占44.99%),其中581例无用药指征。治疗用药423例(占14.08%),均有明确的用药指征;预防性用药2 334例(占77.67%),其中1 326例为推荐用药指征,1 008例为无用药指征;无明确用药目的亦及无用药指征248例(占8.25%)。有适应证者454例(占15.11%),非适应证者2 551例(占84.89%)。影响质子泵抑制剂应用趋势的因素包括年龄、住院时间、手术等8个。结论:该院质子泵抑制剂静脉给药率高,几乎50%为无用药指征;预防性用药率高于治疗用药率,且预防性用药中无用药指征率高;非适应证用药率与适应证用药率的比例约为5.6∶1.0。质子泵抑制剂的不合理应用将增加不良反应的发生概率与患者的医疗费用,采取措施以减少不合理用药是必要的。

OBJECTIVE： To investigate and analyze the application of proton pump inhibitors（ PPI） on inpatients of Guangdong Traditional Chinese Medicine Hospital（ hereinafter referred to as ＂the hospital＂）,so as to promote the rational application of PPI. METHODS： Setting evaluation criterions of clinical application of PPTs by consulting the guidelines,literatures,drug instructions and other documents. 3 005 PPI-using patients＇ medical records during 2015-2016 were randomly selected,then the application of PPI were evaluated and analyzed. Meanwhile,the influence factors of the application tendency of PPI with binary logistic regression were analyzed. RESULTS： Within the randomly selected 3 005 cases,1 352 cases of intravenous administration（ 44. 99%）,of which 581 cases showed no medicinal indications. All the 423 cases（ 14. 08%） for treatment use showed significant medicinal indications. Among2 334 cases（ 77. 67%） for prophylaxis use,1 326 cases showed recommended medicinal indications,1 008 cases showed no medicinal indications; 248 cases（ 8. 25%） for no specific medicinal purpose and showed no medicinal indications. 454 cases（ 15. 11%） showed indications,and 2 551 cases（ 84. 89%） showed no indications. There were 8 factors affected the application tendency of PPI including age,hospital stays,surgery,etc. CONCLUSIONS：The intravenous administration rate of PPI is high,of nearly half showed no medicinal indications. The proportion of prophylaxis use is higher than treatment application,and the rate of no medicinal indications in prophylaxis use is high; the ratio of non-indications to indications was about 5. 6 ∶ 1. 0. Irrational application of PPI will give rise to the increasing of the incidence of adverse drug reactions and medical expenses. It is necessary to take measures to reduce the irrational application of PPI.