某地区子宫肌瘤患者用药现状调查与分析

Investigation and Analysis of the Current Situation of Drug Use in Patients with Uterine Fibroids in a Certain Area

目的了解子宫肌瘤的用药现状及合理性。方法提取医保系统中某地区8家医疗机构2015年至2018年第一诊断为子宫肌瘤患者的资料,回顾性分析药物使用情况及其合理性。结果共纳入1301例患者,平均年龄(47.37±20.38)岁;药品费用占住院费用的23.08%,在药品费用中,排序前三的分别为麻醉相关用药、抗菌药物、电解质;不属于子宫肌瘤围术期预防性使用的抗菌药物费用占抗菌药物费用的36.81%;有适应证的中成药费用仅占中成药费用的19.47%;470例患者无适应证使用质子泵抑制剂;361例患者无适应证使用转化糖电解质注射液;370例患者无适应证使用果糖注射液。结论子宫肌瘤患者用药存在一定不合理现象,主要表现为选药不经济、选择起点过高、无指征使用、个别药物滥用。需加强合理用药培训和监管,节约医疗资源和降低医疗费用。

Objective To understand the current situation of the drug use for uterine fibroids and its rationality.Methods The medical records of patients with first diagnosis of uterine fibroids in 8 medical institutions in a certain area from 2015 to 2018 were extracted from the medical insurance system,the situation drug use and its rationality were analyzed retrospectively.Results A total of 1301 patients were included,with an average age of(47.37±20.38)years.Drug costs accounted for 23.08%of the hospitalization costs,and the top three drugs were narcotic related drugs,antibacterials and electrolytes in the drug costs.The cost of antibacterials which were not used during the perioperative prophylactic use of uterine fibroids accounted for 36.81%of the cost of antibacterials.Chinese patent medicine with indications only accounted for 19.47%of the cost of proprietary Chinese patent medicines.Totally 470 patients used proton pump inhibitors(PPIs)without indication,361 patients used invert sugar electrolyte injection without indication,370 patients used fructose injection without indication.Conclusion There is unreasonable drug use in patients with uterine fibroids,the main manifestations are uneconomical drug selection,too high selection starting point,no indication of use and individual drug abuse.It is necessary to strengthen the training and supervision of rational drug use,save medical resources,and reduce medical costs.