住院患者质子泵抑制剂应用合理性分析

Application Rationality of Proton Pump Inhibitor in Inpatients

目的:探讨住院患者质子泵抑制剂(PPI)应用的合理性,为临床合理用药提供参考。方法:采用回顾性分析方法,选取2015-2017年徐州市儿童医院和徐州市肿瘤医院住院患者病历共314份,对PPI类药物的使用情况、用法用量、适应证等进行分析。结果:314份病历中使用PPI的共241份,总使用率76. 8%,PPI品种主要为奥美拉唑(47. 7%)和泮托拉唑(52. 3%)。预防性用药196例(81. 3%),治疗用药31例(12. 9%),无指征用药14例(5. 8%)。成人预防用药日剂量>40 mg和每日2次给药均为60例,其中泮托拉唑47例,奥美拉唑13例。用药疗程>7 d共64例,其中泮托拉唑52例,奥美拉唑12例。31例预防用奥美拉唑儿童患者每日两次给药3例,用药疗程>7 d共5例,无适应证1例。结论:住院患者PPI应用存在预防用药使用率高、日剂量大、疗程偏长、无指征及不合理联合用药和超说明书用药等问题。

Objective: To explore the application rationality of proton pump inhibitor( PPI) in inpatients,and to provide reference for clinical rational drug application. Methods: Retrospective analysis was adopted. Medical records of 314 inpatients in Xuzhou Children’s Hospital and Xuzhou Tumor Hospital from 2015 to 2017 were selected to analyze the consumption,usage and dosage,and indications of PPI. Results: A total of 241 cases of PPI were used in 314 medical records,with the application rate of 76. 8%. The varieties of PPI were mainly omeprazole( 47. 7%) and pantoprazole( 52. 3%). Totally 196 cases( 81. 3%) were treated with prophylactic drugs,31 cases( 12. 9%) were treated with therapeutic drugs,and 14 cases( 5. 8%) were treated with no indications. Sixty adults received daily dose >40 mg and for twice a day,including 47 patients with pantoprazole and 13 patients with omeprazole. Sixty-four cases were treated>7 d,including 52 patients with pantoprazole and 12 patients with omeprazole. Of the 31 children with omeprazole for prevention,3 cases were given the drug for twice a day,5 cases were given the drug with course >7 d,and 1 case had no indications. Conclusion:There are some problems in PPI application in inpatients,such as high application rate of preventive drugs,large daily dose,long course of treatment,no indications,irrational drug combination and off-label drug use.