我院住院患者麻醉药品和第一类精神药品注射剂使用剩余情况分析

Analysis of the Residues of Anesthetic and Class 1 Psychotropic Drug Injections in Inpatients of Our Hospital

目的:分析咸阳市中心医院住院患者麻醉药品和第一类精神药品注射剂使用剩余情况,为该类药品的规范化管理提供参考依据。方法:采用回顾性研究方法,对咸阳市中心医院2018年全年17104张住院患者麻醉药品和第一类精神药品注射剂处方(包括患者信息、药品信息和临床诊断等)进行统计分析。结果:吗啡注射液的处方最多,使用剩余量(支)最多,为179.2支;芬太尼注射液(0.5 mg)存在剩余处方数仅次于吗啡注射液,为288张;麻黄碱的剩余处方占比最高为26.32%;麻黄碱的剩余量占比最高为15.12%,其次为舒芬太尼,为8.58%;平均单次剩余量最多的是氯胺酮注射液(80 mg/张);平均单次剩余量占规格比最高为氯胺酮(80%),其次为瑞芬太尼(70%);儿童患者由于其特殊性,多数患儿使用麻醉、精一药品会出现剩余。结论:医生应根据病情需要、个体差异选择合适的药品及规格,减少麻醉药品和第一类精神药品的剩余;完善麻醉药品和第一类精神药品精细化管理制度,使其既要"用得上",也要"管得住"。

Objective:To analyze the residues of anesthetic and class 1 psychotropic drug injection after used in patients in order to provide reference for the standardized management of the drugs.Methods:A retrospective research method was conducted by collecting and analyzing the prescriptions(including patient information,drug information,clinical diagnosis,etc.)of 17104 inpatients containing anesthetic and class 1 psychotropic drug injections from January 1 to December 31 in 2018 in Xianyang central hospital.Results:The number of prescriptions containing morphine injection was the highest.The residual dose of morphine injection was also the most(179.2 branches).The residual prescriptions of fentanyl injection(0.5 mg)were the second top(288 prescriptions).The remaining prescription ratio of ephedrine hydrochloride was the most(26.32%).The use residue of ephedrine hydrochloride injection was the largest(15.12%),and followed by sufentanil hydrochloride injection(8.58%).The highest average single residual dose was for ketamine hydrochloride injection(80 mg/prescription).The highest ratio of remaining amount in each prescription was for ketamine hydrochloride injection(80%),and the second top was remifentanil hydrochloride for injection(70%).Due to the particularity of pediatric patients,most of them had residues of anesthetic and class 1 psychotropic drug injections.Conclusion:Doctors should choose appropriate drugs and specifications according to the needs of patients and individual differences so as to reduce the residue of anesthetic and class 1 psychotropic drug injections.The management system for anesthetic and class 1 psychotropic drugs should be improved,so that the drugs are both useful and manageable.