我院围手术期质子泵抑制剂使用情况调查及合理性评价

Investigation and Rationality Evaluation of Proton Pump Inhibitors Use in Our Hospital during Perioperative Period

目的:了解我院围手术期质子泵抑制剂(PPI)的使用合理性,为促进临床合理用药提供参考。方法:通过我院的医院信息系统随机抽取2015年外科系统5月和12月的出院病历,对围手术期PPI的预防使用情况进行回顾性调查,并进行用药合理性评价。结果:522例手术病例中有418例在围手术期使用了PPI预防应激性溃疡,使用率为80.1%,其中排名前3的分别为神经外科、骨科及普通外科(分别为100%、92.6%、92.3%)。使用PPI品种排名前2的分别为泮托拉唑、兰索拉唑(使用频率分别为72.5%、14.8%)。围手术期PPI不合理使用率为70.8%,占比排名前3的分别为给药频次超标、无适应证用药、术后疗程过长(分别为73.7%、64.1%、62.4%)。结论:我院围手术期PPI使用率较高,且部分用药存在不合理现象,相关干预措施有待实施与加强。

OBJECTIVE：To understand the rationality of proton pump inhibitors（PPI） in our hospital during perioperative period,in order to provide reference for rational use of drugs in clinical practice. METHODS：Through randomly collecting discharge cases of surgical system of May and Dec. in 2015 from Hospital Information System,the use of PPI during perioperative period was investigated retrospectively,and the rationality of drug use was evaluated. RESULTS：Among 522 cases,418 cases were given PPI for preventing stress ulcer during perioperative period,with utilization rate of 80.1%. Among them,the top three were neurosurgery,orthopedics and general surgery（100%,92.6% and 92.3% respectively）. Pantoprazole and lansoprazole（72.5%,14.8%,respectively）were the top two categories of the use of PPI. The irrational utilization rate of PPI was 70.8%during perioperative period. In the top three,the number of drugs was exceeded,the drug was not used,course of treatment was too long（73.7%,64.1% and 62.4% respectively）. CONCLUSIONS：The utilization rate of PPI prevention is higher in the department in our hospital during perioperative period,and there is unreasonable situation in some preventive drugs,and the measures need to be implemented and strengthened.