重庆市肿瘤医院2013-2015年麻醉性镇痛药品应用分析

Analysis of the application of narcotic analgesic drugs in Chongqing cancer hospital during 2013-2015

目的了解重庆市肿瘤医院麻醉性镇痛药物在门诊和住院药房的使用情况,探讨该类药物的临床用药结构及变化趋势,为合理用药提供参考。方法提取2013-2015年麻醉性镇痛药物的使用品种及数量,以限定日剂量(defined daily dose,DDD)作为客观指标,对药物销售金额、使用频次、日均费用等数据进行回顾性统计分析。结果该院3年的麻醉性镇痛药物排序基本稳定,总体销售金额逐年上升,口服类缓释制剂的剂型和用量不断增多;门诊以口服类吗啡和羟考酮缓释制剂为主;用药频度稳居第一的是盐酸吗啡缓释片(30mg),垫底的分别是哌替啶和新品种药物氢吗啡酮注射液,住院部以芬太尼类和口服吗啡缓释制剂为主。结论该院麻醉镇痛药物品种和剂型可供临床使用的选择较多,严格遵循口服给药原则,以吗啡类为代表的第三阶梯药物成为癌痛患者进行个体化治疗的首选。

Objective To investigate the use of narcotic analgesic drugs in outpatient and inpatient department in Chongqing cancer hospital,and to provide reference for rational use of drugs by exploring the structure and trend of clinical medication in a hospital.Methods The types and numbers of the use of narcotic analgesic drugs were collected from a hospital during 2013-2015,and then taking defined daily dose（DDD） as objective indicators,analyzed retrospectively in respects of consumption sum,use frequency and DDC,etc.Results For three years,the sort of narcotic analgesic drugs in a hospital remained stable,total consumption sum increased year by year,and the form of drugs and dosage of oral sustained release preparation increased constantly.The outpatient department is mainly oral morphine preparation and oxycodone sustained release preparation.The defined daily dose system（DDDs） of morphine hydrochloride sustained release tablets（30 mg） ranked the top,and the DDDs of pethidine injection and hydromorphone injection which was a new variety ranked the bottomand and the inpatient department is mainly fentanyl preparation and morphine sustained release preparation.Conclusion The varieties and dosage forms of narcotic analgesics in the hospital are more suitable for clinical use.Strictly follow the principle of oral administration,the third ladder drugs represented by morphine are the first choice for patients with cancer pain.