我院儿童静注人免疫球蛋白的使用情况及合理性分析

Application and Rationality of Intravenous Immunoglobulin in Children from Our Hospital

目的:分析我院住院患儿静注人免疫球蛋白(IVIG)的使用情况及其合理性。方法:回顾我院2017年7月至2018年6月住院患儿使用IVIG的情况,判断其诊断是否与说明书适应证一致,并以循证医学指南为依据,对超说明书用药的合理性进行评价。结果:1 813例应用IVIG的患儿中符合适应证的患儿1 185例(65. 36%);超说明书使用的患儿628例(34. 64%),其中"肯定获益"的有178例(28. 34%),"很可能获益"的有4例(0. 64%),"可能获益"的有190例(30. 25%),"不可能获益"的有232例(36. 94%),指南中未提及的适应证有24例(3. 83%)。结论:部分患儿IVIG的超说明书使用仍需进一步规范。

Objective: To analyze the clinical application and rationality of intravenous immunoglobulin( IVIG) in hospitalized children from our hospital. Methods: The application data of IVIG in hospitalized children from our hospital from Jul. 2017 to Jun. 2018 was reviewed. The consistency between the diagnosis and the indication of drug instructions was evaluated. The rationality of the off-label use of IVIG was evaluated according to the evidence-based medicine guidelines. Results: Among 1,813 cases of IVIG-treated children,1,185 cases( 65. 36%) met the approved indications and 628 cases( 34. 64%) were off-label use. Among the off-label use,178 cases( 28. 34%) were definitely beneficial,4 cases( 0. 64%) were probably beneficial,190 cases( 30. 25%) might be beneficial,232 cases( 36. 94%) were unlikely to be beneficial and 24 cases( 3. 83%) were not mentioned in these guidelines. Conclusion: Some off-label use of IVIG in children needs further standardization.