2017—2018年东南大学附属中大医院血必净注射液的使用合理性分析

Analysis on reasonable use of Xuebijing Injection in Zhongda Hospital Southeast University from 2017 to 2018

目的了解东南大学附属中大医院血必净注射液的应用情况,为提高合理应用提供参考。方法调取东南大学附属中大医院2017年1月-2018年12月应用血必净注射液的病历共1 344份,对其临床应用情况进行统计和分析。结果 929份含血必净注射液的病历主要集中在骨科,占69.12%,普外科占24.26%。适应症方面:骨科有适应症使用比例仅为39.3%。用法用量方面,血必净的使用量(50~100 mL)及溶剂体积(100 mL)的合格率分别为98.66%、96.95%,给药频次的合格率仅为17.26%,主要以1次/d给药为主。疗程方面,3~14d给药时间占79.01%。联合用药方面,抗菌药物与血必净注射液联合应用率高达78.94%,其中27.60%抗菌药物使用为预防用药,51.34%抗菌药物使用为抗感染治疗。此外,血必净注射液与丹参川芎嗪、痹祺胶囊、盘龙七片及接骨七里片等联合使用的频次较高,属于重复用药。结论需加强血必净注射液在用法用量及联合用药方面的的处方审核,尤其在使用频次及重复给药方面,需严格把控。此外,血必净注射液在骨科的使用比较多,符合适应症的比例较低,临床药师应加大干预力度、多与临床医生沟通,为医生提供合理用药指导,以促进血必净注射液在临床更加安全、合理及有效的应用。

Objective To understand the application of Xuebijing Injection in Zhongda Hospital Southeast University, and to provide reference for improving the rational use. Methods A total of 1 344 medical records of application of Xuebijing Injection from January 2017 to December 2018 in Zhongda Hospital Southeast University were collected for statistics and analysis of its clinical application. Results The medical records(929 cases) of Xuebijing Injection were mainly concentrated in Department of Orthopedics, accounting for 69.12%, and Department of General Surgery accounted for 24.26%. The proportion of application of Xuebijing Injection in Department of Orthopedics with indications was only 39.3%. In terms of usage and dosage, the pass rate of Xuebijing Injection with usage amount of 50 - 100 mL and solvent volume of 100 mL were 98.66% and 96.95%, respectively. The pass rate of frequency of administration was only 17.26%, mainly for once-a-day dosing. In terms of course of treatment, the administration time of 3 - 14 d accounted for 79.01%. In terms of combined medication, the combined application rate of antibacterial drugs and Xuebijing Injection accounted for 78.94%, of which 27.60% were used for preventive medication and 51.34% were used for anti-infective treatment. In addition, Xuebijing Injection was more frequently used in combination with Danshen Chuanxiongqin Injection, Biqi Capsules, Panlongqi Tablets and Jieguqili Tablets, which was repetitive medication. Conclusion The prescription review of Xuebijing injection in terms of dosage and combined medication, especially in terms of frequency of use and repeated administration should be strengthened. In addition, the use of Xuebijing Injection is more rampant in the use of Department of Orthopedics at present. The proportion of eligible indications is low in Department of Orthopedics. Clinical pharmacists should increase intervention and communicate with clinicians to provide doctors with reasonable medication guidance to promote Xuebijing Injection more safe, reasonable, and effective in clinical applications.