某肿瘤医院儿童肿瘤科预防性止吐用药分析

Analysis of Preventive Antiemetic Drugs in Pediatric Oncology Department of a Tumor Hospital

目的分析某院儿童肿瘤科预防性止吐用药,为临床用药提供参考。方法回顾性调研该肿瘤医院儿童肿瘤科2018年10~12月的化疗用药和预防性止吐用药医嘱。参照NCCN指南,对化疗用药的致吐等级进行判定,依照致吐等级对止吐用药方案进行分析,并分析5-TH3受体拮抗剂医嘱的合理性。结果共获得有效病历228例,其化疗用药的致吐等级情况是高致吐97例(42.5%),中度致吐123例(54.0%),低致吐3例(1.3%),微致吐5例(2.2%);止吐用药选择不合理有133例(46.2%),重复给药61例(26.8%);291条5-TH3受体拮抗剂医嘱当中,超剂量给药133条(45.7%),超年龄用药20条(6.9%)。结论该院儿童肿瘤科预防性止吐用药存在药品选用不合理、重复用药、给药剂量不当和超年龄给药等情况,临床应加强预防性止吐用药的管理,杜绝不合理用药现象。

OBJECTIVE To analyze the preventive antiemetic drugs in the department of pediatric oncology in a hospital,and to provide reference for clinical medication.METHODS A retrospective study was conducted on the medication orders of chemotherapeutic drugs and preventive antiemetic drugs in the department of pediatric oncology of the tumor hospital from October to December 2018.The emetogenic grade of the chemotherapy drugs was determined according to the NCCN guidelines.The use of antiemetic regimens was analyzed according to the emetogenic grade of the chemotherapy drugs.The rationality of 5-TH3 receptor antagonist medication orders were analyzed.RESULTS A total of 228 cases with chemotherapy were obtained.The emetogenic grade of the chemotherapy drugs used in those cases 97(42.5%)high emetic risk,123(54.0%)moderate emetic risk,3(1.3%)low emetic risk,5(2.2%)minimal emetic risk.There were 133 cases(46.2%)of irrational choice of antiemetic drugs,and 61 cases(26.8%)of repeated administration.There were 291 medication orders of 5-TH3 receptor antagonists,among them 133(45.7%)were overdosed,20(6.9%)were overage.CONCLUSION The preventive antiemetic drugs used in the department of pediatric oncology of this hospital include unreasonable drug selection,repeated administration,improper dosage and overage administration.The management of preventive antiemetic drugs should be strengthened in clinical practice to eliminate the phenomenon of unreasonable drug use.