围术期使用抑酸药预防应激性溃疡的临床应用现状及PPIs安全性认知度的多中心问卷调查

Current Status of the Use of Acid-suppressing Drugs in the Perioperative Prevention of Stress Ulcers and PPIs Safety Knowledge:A Multicenter Questionnaire Survey

目的:了解外科医生围术期使用抑酸药预防应激性溃疡(SU)的用药现状及质子泵抑制药(PPIs)安全性相关知识的认知度。方法:使用自行编制的调研问卷,采用横断面现场调研的方法开展问卷调研,问卷内容包括:一般资料; PPIs安全性知识得分;是否参加过SU培训、知识获取途径、预防SU指南了解程度、预防SU抑酸药应用现状等。结果:调查问卷有效率为98%(1 351/1 374)。使用抑酸药预防SU现状方面,多数医生偏好使用PPIs,55. 14%(745名)医生偏好静脉给药,28. 94%(391名)医生选择静脉序贯口服给药,仅15. 91%(215名)选择口服给药。PPIs安全性9道问题中,仅15. 10%的医生答对5道以上。其中"哪种PPIs药物相互作用最多"认知度最高,"PPIs长期应用可能导致骨折风险"的认知度最低(19. 25%),PPIs安全性培训中应重点关注这部分人群。多因素分析结果显示,医院级别、是否为教学医院、是否阅读过指南、知识获取途径为参考资料和继续教育与PPIs安全性知识掌握程度有关。结论:目前预防术后应激性溃疡存在用药起点高、静脉给药等问题,PPIs安全性知识缺乏。建议对目标人群开展针对性专题培训,提高抑酸药的合理使用水平。

Objective：To understand the current status of the use of acid-suppressing drugs in the perioperative prevention of stress ulcers and the knowledge of PPIs safety. Methods：The cross-sectional field surveys were conducted to conduct self-designed questionnaire surveys. The contents of the questionnaire included： general information; PPIs safety knowledge scores; whether to participate in the SU training,knowledge access route,know SU guidelines,and prevention of SU antacid application status. Results：The effective rate of the questionnaire was 98%（1 351/1 374）. Most doctors prefer to use PPIs,55. 14%（745/1 351） doctors prefer intravenous administration,28. 94%（391/1 351） doctors choose intravenous transfer oral,only 15. 91%（215/1 351） choose oral administration. Only 15. 10% of doctors answered 5 or more qustions correctly. Among them,＂what type of PPIs drug interacts most＂was the most recognized,and＂PPIs longterm use may lead to fracture risk＂was the lowest（19. 25%）,and PPIs safety training should focus on this group of people. Multivariate analysis of the results showed that the hospital level,whether it was a teaching hospital,whether or not know the guideline,knowledge acquisition methods as reference materials or continuing education were related to the PPIs safety knowledge mastery. Conclusion： At present,there were some problems such as the high starting point of drug use and intravenous administration in the prevention of postoperative stress ulcer,and the lack of knowledge of PPIs safety. It was suggested that targeted training be conducted for the target population to raise the level of rational use of anti-acid drugs.