医院骨科围术期质子泵抑制剂应用评价分析

Evaluation and Analysis of the Application of Proton Pump Inhibitors During Perioperative Period of Orthopedics in a Hospital

目的调查医院骨科围术期质子泵抑制剂(PPIs)的应用情况和合理性。方法收集医院骨科2017年1月至12月围术期使用PPIs的患者478例,采用回顾性调查法对其应激性溃疡风险因素进行评估。结果 270例(56. 49%)患者无应激性溃疡风险因素;围术期PPIs疗程短于3 d的患者107例次(20. 62%),疗程为8～14 d的患者106例次(20. 42%); 258例次(97. 72%)使用奥美拉唑的患者日剂量为40 mg,使用泮托拉唑的患者日剂量均为40 mg。结论医院骨科围术期应用PPIs预防应激性溃疡时,存在无指征预防用药、给药方式不恰当、疗程过长及用量过大等不合理情况。应结合已有的推荐意见,制订PPIs在骨科围术期的使用规范,以指导医院骨科围术期PPIs的合理使用。

Objective To investigate the application and rationality of proton pump inhibitors(PPIs)during perioperative period of orthopedics in our Hospital.Methods A total of478patients treated with PPIs in the Department of Orthopedics in our hospital from January to December in2017were enrolled,and the risk factors of stress ulcer in patients treated with PPIs were evaluated by retrospective investigation method.Results Totally270patients(56.49%)had no risk factors for stress ulcer,107cases(20.62%)were treated with PPIs for less than3d in perioperative period,106cases(20.42%)were treated with PPIs for8-14d,and258cases(97.72%)received omeprazole at a daily dose of40mg,all the patients received pantoprazole at a daily dose of40mg.Conclusion When PPIs were used to prevent stress ulcer during perioperative period of orthopedics in the hospital,there were some unreasonable situations,such as no indication of preventive medication,inappropriate administration mode,long course of treatment and excessive dosage.In order to guide the rational use of PPIs during perioperative period of orthopedics in the hospital,we should formulate the criteria for the use of PPIs during perioperative period of orthopedics in combination with the existing recommendations.