质子泵抑制剂在心血管住院患者中的用药情况及合理性分析

Analysis on the application of proton pump inhibitors in cardiovascular inpatient

目的:调查住院患者质子泵抑制剂(PPIs)的使用情况并对其合理性进行评价,为临床合理用药和管理提供参考。方法:采取回顾性研究方法,通过HIS系统调取我院住院2019年PPIs使用情况,对使用金额、用药频度及科室分布等进行统计,并随机抽取2019年9月心内科和心外科PPIs出院患者病历200份,针对适应证、药物选择、给药时机及疗程等信息评价其合理性。结果:雷贝拉唑肠溶胶囊金额占PPIs总金额的31.33%,排第1位;注射剂中注射用泮托拉唑金额最高,占PPIs总金额的20.68%,排第2位。心内科与心外科是PPIs使用量排前两位的科室,分别占全院PPIs金额的38.90%和20.29%。心内科100例患者使用PPIs均合理。心外科100例患者中,9例(9.0%)为无指征用药,4例术前使用PPIs,87例术后使用PPIs。预防应激性溃疡疗程为1~19 d,48例(48.0%)患者在危险因素消失后仍使用PPIs,另有8例(8.0%)患者使用PPIs从术后至出院,用药疗程普遍偏长。结论:我院心内科PPIs使用合理性高,心外科PPIs不合理用药比例较高,应制定预防用PPIs使用规范,加强用药干预,防止过度使用。

Objective:To evaluate the application of proton pump inhibitors(PPIs)in inpatients of our hospital in order to provide references for clinical rational drug use and management.Methods:Data of PPIs used in inpatients during 2019 was retrospectively retrieved through hospital information system(HIS)of our hospital and analyzed in terms of consumption sum,DDDs,distribution of departments,etc.Furthermore,200 medical records of discharged patients using PPIs in September 2019 were randomly extracted from the department of cardiology and cardiosurgery and then the rationality of PPIs was evaluated according to the indication,drug selection,medication time,dosage,etc.Results:Ranked by the consumption sum,the top 1 was rabeprazole enteric-coated capsules(31.33%).The top 2 was pantoprazole for injection(20.68%).Ranked by the distribution of department,the top 1 and top 2 were the department of cardiology and cardiosurgery.Their consumption sums of PPIs were accounted for 38.90%and 20.29%respectively.The use of PPIs was reasonable in 100 patients from the department of cardiology.Among the 100 patients from the department of cardiosurgery,9 patients(9.0%)used PPIs without indications.4 patients used PPIs before the operation,and 87 patients used PPIs after the operation.The course of PPIs treatment for prophylaxis of stress ulcer was from 1 d to 19 d.48 patients(48.0%)still used PPIs after the disappearance of risk factors and another 8 patients(8.0%)used PPIs from post-operation to discharge.The course of PPIs treatment was generally longer.Conclusion:The use of PPIs in the department of cardiology in our hospital was reasonable.But the proportion of irrational use of PPIs was relatively high in the department of cardiosurgery.Specifications of PPIs should be formulated and drug intervention should be strengthened in order to prevent overuse of PPIs.