基层医院抑酸药物预防成人应激性溃疡的处方点评

Stress ulcer prophylaxis in primary hospital patients: an investigation and analysis of antacids

目的了解县级医院住院患者预防应激性溃疡抑酸药的使用情况,评价其合理性。方法查阅川东北地区5家县级综合医院(1家三级乙等,4家二级甲)2017年10月1日~12月31日住院患者的病历资料,每个医院随机抽查80份病历,制订相应的评价标准,评价抑酸药物使用情况。结果最后纳入病例175例,抑酸药倾向选择基本药物(奥美拉唑、西咪替丁);68例患者用药合理,总体合理使用率为38.86%,其中西咪替丁合理使用率最高为61.29%,雷尼替丁最低为14.29%。适应证不适宜71例(66.35%),疗程不适宜28例(26.17%),存在不良的药物相互作用2例(1.87%)。结论基层医院应加强住院患者抑酸药预防应激性溃疡的管理,尤其是严格按照适应证用药。

Objective To Investigate the use of antacids for stress ulcer prevention in orthopaedic surgery and evaluated its rationality.Methods To formulate valuation standards of antacids used for stress ulcer prophylaxis, 400 patients using antacids were chose from October 1, 2015 to December 31, 2015. Statistics analysis was applied in the antacids use situation.The rationality was assessed. Results There were 175 cases were selected with the propensity to choose essential drugs(Omeprazole, cimetidine). Reasonable treatment had 68 patients(38.86%). The cimetidine reasonable utilization rate was up to 61.29%. The ranitidine lowest was to 14.29%. 71 cases(66.35%) were with no indication for prophylaxis., 28 cases(26.17%) were too long in treatment and 2 cases(1.87%) of drug interactions. Conclusion More powerful management on antacids for preventing the stress ulcer is needed, especially in strict accordance with the indications of medication.