徐州市妇幼保健院9591张早期妊娠终止妊娠处方用药分析

Analysis on Drug Application of Pregnancy Termination in Early Trimester on 9591 Prescriptions in Xuzhou Maternal and Child Health Care Hospital

目的:了解徐州市妇幼保健院(以下简称"我院")早期妊娠终止妊娠情况,探讨其合理性,为临床合理用药提供参考。方法:通过临床药学管理系统,抽取2016年1月—2017年3月我院早期妊娠终止妊娠处方9 591张,对处方中终止妊娠方式、联合用药情况及用药合理性进行统计分析。结果:9 591张处方中,使用终止妊娠药物处方所占比例较低(2 913张,占30.37%);三联用药处方所占比例最高,高达47.58%(4 563张);单一用药处方所占比例最低,仅3.76%(361张);常用药物包括中成药、抗菌药物、雌孕激素类药物(避孕药)、术中用药和终止妊娠药物等5类。不合理处方680张,其中最突出的问题是联合用药不适宜(291张,占42.79%),其次为用药选择不合理(192张,占28.24%)和用药疗程过长(175张,占25.74%)。结论:我院早期妊娠终止妊娠处方用药基本合理,但仍存在问题,如少数使用终止妊娠药物处方中无指征使用抗菌药物;人工流产术围术期预防性使用抗菌药物的用药选择、给药时间欠妥;中成药存在重复用药、疗程过长等。应针对问题予以整改。

OBJECTIVE： To investigate pregnancy termination in early trimester in Xuzhou Maternity and Child Health Care Hospital（ hereinafter referred to as ＂our hospital＂） and probe into the rationality,so as to provide references for clinical rational drug application. METHODS： 9 591 prescriptions of pregnancy termination in early trimester from Jan. 2016 to Mar. 2017 in our hospital were extracted through the clinical pharmacy management system,the prescriptions were analyzed in terms of the ways of pregnancy termination,drug combination and rationality of drug application. RESULTS： Of9 591 prescriptions,the application of drugs for pregnancy termination accounted for a relatively low proportion（ 2 913 prescriptions,30. 37%）; prescriptions of three-drug combination took the highest proportion with 47. 58%（ 4 563 prescriptions）; prescriptions of single drug application took the lowest proportion with 3. 76%（ 361 prescriptions）; 5 categories of frequently used drugs including Chinese patent medicine, antibiotics, progestogens（ contraceptives）,intraoperative medication and drugs for pregnancy termination. There were 680 irrational prescriptions,mostly was inappropriate drug combination（ 291 prescriptions, 42. 79%）, secondly were unreasonable drug selection（ 192 prescriptions,28. 24%） and overlong treatment course（ 175 prescriptions,25. 74%）. CONCLUSIONS： Drug application of pregnancy termination in early trimester in our hospital is basically rational,however,problems like non-indication medication of antibiotics in a few prescriptions of pregnancy termination; improper drug selection and administration time of prophylactic application of antibiotics in perioperative period of abortion; repetitive medication of Chinese patent medicine and overlong treatment course are still exist,which should be rectified and reformed.