头孢菌素类药物不良反应发生原因及对策

Causes and countermeasures of adverse reactions of cephalosporins

目的探讨头孢菌素类药物不良反应发生原因及对策。方法 334例住院治疗患者,按用药途径不同分为参照组和研究组,每组167例。两组患者住院治疗期间均使用头孢菌素类药物进行抗感染治疗,参照组采用静脉给药方式,研究组采用口服用药方式。记录两组患者不良反应类型,比较两组患者不良反应发生情况,并总结分析不良反应发生原因。结果两组患者头孢菌素类药物不良反应类型主要为免疫系统、泌尿系统、消化系统及循环系统。参照组患者中共发生药物不良反应51例,其中免疫系统21例、泌尿系统15例、消化系统11例、循环系统4例,不良反应发生率为30.54%(51/167);研究组患者中共发生药物不良反应24例,其中免疫系统11例、泌尿系统6例、消化系统5例、循环系统2例,不良反应发生率为14.37%(24/167),研究组不良反应发生率低于参照组,差异有统计学意义(χ~2=12.535, P=0.000<0.05)。334例头孢菌素类药物治疗的患者中共发生不良反应75例,个体差异是造成头孢菌素类药物不良反应的主要原因,其次分别为用药方法不当、药物过量、饮食刺激、滴速过快、年龄、饮酒,其中个体差异18例(24.00%),用药方法不当16例(21.33%),药物过量13例(17.33%),饮食刺激9例(12.00%),滴速过快8例(10.67%),年龄因素6例(8.00%),饮酒5例(6.67%)。结论头孢菌素类药物口服用药可降低药物不良反应,对药物不良反应发生原因的分析可帮助临床制定合理的用药措施,规避不良反应风险,确保用药合理性。

Objective To discuss the causes and countermeasures of adverse reactions of cephalosporins.Methods A total of 334 hospitalized patients were divided into control group and research group according to the route of medication,with 167 cases in each group.Both groups received cephalosporins for anti-infective treatment during hospitalization.The control group used intravenous administration,and the research group used oral medication.The types of adverse reactions in the two groups were recorded,the occurrence of adverse reactions in the two groups was compared,and the causes of adverse reactions were summarized and analyzed.Results The main adverse reactions of cephalosporins in the two groups were immune system,urinary system,digestive system and circulatory system.In the control group,there were 51 cases of adverse drug reactions,including 21 cases of immune system,15 cases of urinary system,11 cases of digestive system,and 4 cases of circulatory system,with adverse reaction rate as 30.54%(51/167).In the research group,there were 24 cases of adverse drug reactions,including 11 cases of immune system,6 cases of urinary system,5 cases of digestive system,and 2 cases of circulatory system,with adverse reaction rate as 14.37%(24/167).The incidence of adverse reactions of the research group was lower than that of the control group,and the difference was statistically significant(χ2=12.535,P=0.000<0.05).A total of 75 cases of adverse reactions occurred in 334 patients treated with cephalosporins.Individual differences were the main reason for the adverse reactions of cephalosporins,followed by improper medication,overdose,dietary irritation,rapid drip rate,age and drinking.Among them,there were 18 cases(24.00%)of individual differences,16 cases(21.33%)of improper medication,13 cases(17.33%)of drug overdose,9 cases(12.00%)of dietary irritation,8 cases(10.67%)of rapid drip rate,6 cases(8.00%)of age factors and 5 cases(6.67%)of drinking.Conclusion Oral administration of cephalosporins can reduce adverse drug reactions.The analysis of the causes of adverse drug reactions can help clinicians formulate reasonable medication measures,avoid the risk of adverse reactions,and ensure the rationality of medication.