手足口病住院患儿用药分析与评价

Analysis and Evaluation of Drug Use in Hospitalized Children with Hand-Foot-Mouth Disease

目的:了解手足口病住院患儿用药情况及趋势,为临床合理用药提供参考。方法:以主要诊断“手足口病”为关键词,抽取某院2015年1月至2017年12月手足口病住院患儿电子病历245份,采用金额排序法和频度分析法对该院手足口病住院患儿用药品种、用药特点进行回顾性分析。结果:手足口病患儿年龄较小,以男性幼儿为主,男女比例2.02∶1,平均住院时间6.39d;人均住院费用和人均药品费用呈逐年降低趋势,但人均药占比始终保持在40%左右;手足口病住院患儿用药以营养支持类药物、抗菌药物、中药制剂、抗病毒药物、免疫调节药物、糖皮质激素为主。结论:该院手足口病住院患儿的治疗以中西医结合、对症治疗为主;营养支持类药物、抗菌药物存在不合理使用现象,抗病毒药物单磷酸阿糖腺苷注射剂存在无适应证用药问题;中药治疗以注射剂为主,在总药费中占比较高,人均花费较大,值得进一步探讨。

Objective:To investigate the current status and trend of drug use in hospitalized children with hand-foot-mouth disease,so as to provide reference for clinical rational drug use.Methods:Taking the main diagnosis of Hand-Foot-Mouth Disease as the keyword,245 electronic medical records of hospitalized children with hand-foot-mouth disease from Jan.1st,2015 to Dec.30th,2017 were collected.Medication varieties and characteristics of hospitalized children with hand-foot-mouth disease in the past three years were analyzed retrospectively by ranking of consumption sum and defined daily dose system(DDDs).Results:Children with hand-foot-mouth disease were younger,and mainly for males,with a male to female ratio of 2.02∶1,and the average hospitalization time was 6.39 d.The per capita hospitalization cost and per capita drug cost were in a decreasing trend year by year,but per capita drug proportion remained at 40%.The hospitalized children with hand-foot-mouth disease were mainly treated with nutrition support drugs,antibiotics,traditional Chinese medicine preparations,antiviral drugs,immunomodulatory drugs and glucocorticoids.Conclusion:The treatment of hospitalized children with hand-foot-mouth disease in this hospital is mainly the combination of traditional Chinese medicine and western medicine,and symptomatic treatment.The use of nutrition support drugs and antibiotics is irrational,and the antiviral drugs such as adenosine monophosphate injection has no indications.Traditional Chinese medicine treatment is mainly injections,which accounts for a relatively high proportion of total drug costs and has a large per capita cost,and deserves further regulation.