96例地塞米松注射剂致恶心呕吐反应回顾性分析

A retrospective analysis on the nausea and vomiting caused by dexamethasone injection:basing on the adverse drug reactions from 96 cases

目的:回顾性分析地塞米松注射剂致恶心呕吐反应发生情况。方法:通过医院电子病历系统和国家药品不良反应监测系统,收集2014年1月1日-2018年12月31日,在某口腔三级甲等医院住院治疗期间使用地塞米松磷酸钠注射液的患者资料,采用描述性分析对总体人群和不良反应发生人群的基本特点、不良反应发生与处理和药物使用情况进行分析,使用χ^2检验和独立样本T检验进行样本结构差异分析。结果:5年共有28959人次患者住院治疗,使用地塞米松注射剂后发生恶心、呕吐96人次,发生率为0.3%。总体人群和不良反应发生人群间男性比例(52.1%vs 26.0%,P<0.01)、平均年龄(35.1 vs 26.3,P<0.01)存在显著性差异。96例不良反应均为一般程度,94例发生在用药后10 min内,91例未经处理症状自行缓解,5例采取了停药或降低输液速度、给予甲氧氯普胺注射液或维生素B6注射液后症状缓解,3例再次使用药物后出现同样反应,79例存在合并用药的情况,所有药物使用均符合说明书内容规定。结论:地塞米松注射剂与恶心呕吐反应之间是"肯定"的关联性关系,女性和较低年龄者更容易发生该反应,用药后10 min内需重点关注,一般自行缓解,症状严重者需停药,协助清洁口鼻腔,必要时给予甲氧氯普胺或维生素B6。

OBJECTIVE To retrospective analyze the incidence of nausea and vomiting caused by dexamethasone injection.METHODS The data of patients who used dexamethasone sodium phosphate injection during hospitalization in an oral tertiary care hospital from January 1,2014 to December 31,2018 were collected through the hospital electronic medical record system and the national adverse drug reaction monitoring system.Descriptive analysis was used to analyze the basic characteristics,occurrence and treatment of adverse reactions and drug use of the overall population and the population with adverse reactions.Chi-square test and independent sample T test were used to analyze the differences in sample structure.RESULTS A total of 28,959 patients were hospitalized during the 5-year period,and 96 patients developed nausea and vomiting after the use of dexamethasone injection,with an incidence of 0.3%.There was a significant difference in the proportion of males(52.1%vs 26.0%,P<0.01)and mean age(35.1 vs 26.3,P<0.01)between the overall population and the population with adverse reactions.96 cases of adverse reactions were of general severity,94 cases occurred within 10 min after medication,91 cases of untreated symptoms were relieved spontaneously,5 cases were relieved after drug withdrawal or infusion rate reduction,metoclopramide injection or vitamin B6 injection was given,3 cases had the same reaction after re-use of drugs,79 cases had concomitant medication,and all drug use met the requirements in the instructions.CONCLUSION There is a"positive"correlation between dexamethasone injection and nausea and vomiting.Women and younger patients are more likely to have this reaction,and more attention was needed in 10 minutes after transfusion.Most ADRs could be relieved spontaneously.In severe cases,the drug should be withdrawn and the oronasal cavit should be cleaned as appropriate,and metoclopramide or vitamin B6 should be given when necessary.