2017—2018年西安市第四医院中药注射剂的使用合理性分析

Analysis on reasonable use of traditional Chinese medicine injection in Xi’an No.4 Hospital from 2017 to 2018

目的了解西安市第四医院中药注射剂的使用情况,为临床合理用药提供参考。方法采用回顾性分析方法,随机抽取西安市第四医院2017年1月-2018年6月住院患者使用中药注射剂的病历750份,对其进行统计、分析。结果抽取的750份病历中,不合理医嘱共111份。其中不合理用药最多的是骨科,达44份(39.64%);适应症不适宜和多组液体间未冲管问题最多,均占不合理医嘱的35.14%,其次为中西药配伍不适宜问题,占19.82%;适应症不适宜和多组液体间未冲管出现最多的药物均为注射用丹参多酚酸盐,中西药配伍不适宜问题出现最多的是舒血宁注射液与注射用兰索拉唑或注射用奥美拉唑配伍禁忌;溶媒选择不当的药物主要为红花注射液;超疗程用药的药物有注射用丹参多酚酸盐和注射用血栓通。结论西安市第四医院中药注射剂的使用存在一定问题,仍需加强中药注射剂合理使用的监管,以提高中药注射剂在临床应用中的安全性、有效性、合理性。

Objective To understand the use of traditional Chinese medicine(TCM) injection in Xi’an No.4 Hospital, and in order to provide reference for clinical rational use of drugs. Methods In retrospective analysis, 750 inpatient prescriptions including TCM injection were collected from Xi’an No.4 Hospital from January 2017 to June 2018, and the application of TCM injection was analyzed for statistical analysis. Results Of the 750 medical records collected, 111 cases were unreasonable. Among them, Department of Orthopedics had the most unreasonable medication(44 cases), accounting for 39.64%. The problem of inappropriate indications and non-flushing of multiple groups of liquids was the most, both accounting for 35.14%. Then compatibility of Chinese and western medicine was followed, accounting for 19.82%. Salvia Polyphenolate for injection had the most indications for inappropriate indications and non-flushing of multiple groups of liquids. The most inappropriate problem in the compatibility of Chinese and western medicines was the combination of Shuxuening Injection and Lansoprazole for injection or Omeprazole for injection. Honghua Injection had the most cases of improper choice of solvent. Salvia Polyphenolate for injection and Xueshuantong for injection had the most cases of more than guid course of medication. Conclusion There are some unreasonable situations of TCM injection in Xi’an No.4 Hospital, and it is still necessary to strengthen the supervision of the rational use of TCM injections in order to improve the safety, effectiveness, and rationality of TCM injections in clinical application.