伏立康唑的抗感染效果分析及其用药合理性评价

Analysis of Anti-infection Effect of Voriconazole and Its Rational Evaluation of Drug Use

目的评价某医院住院患者伏立康唑的临床合理应用情况。方法利用医院HIS系统,调取2017年4月到2018年3月有使用伏立康唑的患者病历号,通过病历号查找电子病历系统中患者的相关信息。用Excel 2007记录相关情况并进行综合分析。结果共106例患者使用了伏立康唑,其中有97例进行病原微生物检查,共检出有真菌感染的患者76例(占71.70%)。有80例(占75.47%)进行真菌1,3-β-D葡聚糖检测(G试验),其中阳性30例(占37.50%);有34例(占32.08%)进行半乳甘露聚糖检测(GM试验),其中阳性14例(占41.18%)。有92例患者入院后和出院前均有进行血常规检查,白细胞(WBC)在治疗前后发生较明显的变化,说明患者的病情有明显好转。药品的使用以联合用药为主,其中,联合使用抗菌药物的有100例,联合使用糖皮质激素类药的有54例,联合使用其他抗真菌药物的有44例。共有不合理用药病历21份,占总病历数的19.81%。结论伏立康唑治疗肺曲霉菌感染疗效好,不良反应少,但临床应用仍存在一些不足,所以相关部门应引起重视,共同促进伏立康唑的安全、合理使用。

OBJECTIVE To evaluate the rational clinical application of voriconazole on the inpatients in certain hospital.METHODS The number of medical records of the inpatients taken voriconazole from April,2017 to March,2018 were sorted out by the hospital′s HIS system.Then the related information of these inpatients were found out by the electronic patient records system.Excel 2007 was applied to record the relevant circumstances and to make comprehensive analysis.RESULTS among these 106 cases,97 cases examined pathogenic bacteria and 76 cases(71.70%)were found fungal infection.80 cases had the 1,3β-D glucan test(G test)and 30 cases(37.50%)were found positive.34 cases detected the galactomannan(GM test),in which 14(41.18%)were found positive.In 92 cases,the inpatients had blood routine examinations after admission and before discharge.The obvious variations of leucocyte level in blood showed that these inpatients were markedly improved.In these cases,drug combination therapy was the majority.Among these,combined use of antibiotics was found in 100 cases;combined use of glucocorticoids was found in 54 cases;combined use of other antifungal agents was found in 44 cases.Irrational drug use was found in 21 medical records,accounting for 19.81%.CONCLUSION Voriconazole has a good efficacy and less adverse reaction in the treatment of pulmonary aspergillosis,though there is still some deficiency in clinical application.Therefore,close attention should be paid to this use of voriconazole,which can improve the safety and rationality in the application of voriconazole.