2014—2017年贵州省肿瘤医院肿瘤内科住院患者三阶梯止痛药应用分析

Analysis on Application of Three-Step Analgesic Ladder Drugs on Inpatients in Medical Oncology in Guizhou Cancer Hospital During 2014-2017

目的:了解贵州省肿瘤医院(以下简称"我院")肿瘤内科住院患者三阶梯止痛药的使用情况,促进临床合理用药。方法:对2014—2017年我院7个肿瘤内科三阶梯止痛药的品种、规格、使用量、销售金额、用药频度(defined daily dose system,DDDs)、限定日费用(defined daily cost,DDC)和药品销售金额排序(B)/DDDs排序(A)的比值等进行统计分析。结果:2014—2017年,我院肿瘤内科使用的三阶梯止痛药主要有18个品种,其销售金额逐年平稳增长,第三阶梯止痛药的销售金额最高;第二、三阶梯止痛药的使用量和累积DDDs较高,DDDs排序居前5位的药品依次为氨酚双氢可待因片、双氯芬酸钠缓释胶囊、盐酸曲马多缓释胶囊、硫酸/盐酸吗啡缓释片及盐酸羟考酮缓释片;氨酚双氢可待因片、双氯芬酸钠缓释胶囊和盐酸曲马多缓释胶囊的DDC<12元、B/A>1,芬太尼透皮贴剂和枸橼酸舒芬太尼注射液的DDC>110元,B/A<1,盐酸吗啡片、盐酸/硫酸吗啡缓释片、盐酸吗啡注射液及盐酸曲马多注射液等的B/A接近于1。结论:我院肿瘤内科三阶梯止痛药的使用为口服优先,按阶梯给药,并遵循整体、合理、规范和经济原则,基本符合癌痛三阶梯止痛用药的原则,临床医师优化阶梯给药的意识不断增强,但仍需进一步加强监督和管理,促进临床合理用药。

OBJECTIVE： To investigate the application of three-step analgesic ladder drugs on inpatients in medical oncology in Guizhou Cancer Hospital （ hereinafter referred to as ＂our hospital＂ ）, so as to promote clinical rational drug application. METHODS ： Categories, specifications, usage amounts, consumption sums, defined daily dose system （DDDs）, defined daily cost （DDC） and the ratio of sequence of consumption sum （B） to sequence of DDDs （A） of three-step analgesic ladder drugs in 7 medical oncology departments in our hospital during 2014-2017 were collected and analyzed. RESULTS： During 2014-2017, there were 18 categories of three-step analgesic ladder drugs were used in medical oncology in our hospital, with steady increasing consumption sum by years, the consumption sum of analgesic drugs at the third ladder was the highest; the usage amounts and accumulated DDDs of analgesic drugs at the second and third ladder were higher, the top 5 drugs ranked in DDDs were respectively Aminophenol dihydrocodeine tablet, Diclofenac sodium sustained release capsules, Tramadol hydrochloride sustained release capsules, Morphine sulfuric acid/morphine hydrochloride tablets and Hydroxyketone hydrochloride sustained release tablets; the DDC of Aminophenol dihydroeodeine tablet, Diclofenac sodium sustained release capsules and Tramadol hydrochloride sustained release capsules were 〈 12 yuan, with B/A of 〉 1; the DDC of Fentanyl transdermal patches and Sufentanil citrate injection were 〉 110 yuan, with B/A of 〈 1 ; the B/A of morphine hydrochloride tablets, Morphine sulfuric acid/morphine hydrochloride tablets, morphine hydrochloride injection and tramadol hydrochloride injection were closed to 1. CONCLUSIONS： The application of three-step analgesic ladder drugs in our hospital is on orally taken for priority, which follows three-step analgesic ladder with integral, rational, standard and economic medication rule. Clinicians should keep optimizing laddered medication, which needs further reinforcement in supervision and management, so as to promote clinical rational drug application.