328例住院患者应用甲磺酸加贝酯的合理性分析

Application Rationality of Gabexate Mesilate in 328 Inpatients

目的:调查该院住院患者甲磺酸加贝酯的使用情况,并评价用药合理性。方法:调取2019—2020年该院328例使用甲磺酸加贝酯的住院患者病历,收集患者基本信息、住院信息和用药信息等,根据国内外指南和文献对用药合理性进行评价;从中筛选出诊断为急性胰腺炎的非手术患者286例,初步探讨甲磺酸加贝酯不同给药方案对治疗结局的影响。结果:328例使用甲磺酸加贝酯的住院患者中,超说明书适应证用药22例(占6.71%),均为手术患者;溶剂不适宜94例(占28.66%),93例使用0.9%氯化钠注射液作为溶剂,1例使用10%葡萄糖注射液作为溶剂;滴注速度过快7例(占2.13%),其滴注速度>2.5 mg/(kg·h);与乌司他丁联合应用161例(占49.09%)。是否联合乌司他丁、不同给药疗程(≤5 d和>6 d)对患者的实验室指标、腹痛缓解时间和住院时间均无显著影响(P>0.05)。结论:甲磺酸加贝酯的临床应用尚存在不足,临床应予以高度重视,促进合理用药。

OBJECTIVE:To investigate the application of gabexate mesilate in inpatients from this hospital,so as to evaluate its rationality.METHODS:Medical records of 328 inpatients using gabexate mesilate in this hospital during 2019-2020 were acquired,patients’general information,hospitalization information and medication information were collected,the medication rationality was evaluated according to domestic and overseas guidelines and literature;totally 286 non-surgical patients diagnosed with acute pancreatitis were screened out,effects of different dosage regimens of gabexate mesylate on the treatment outcomes were preliminarily discussed.RESULTS:Among the 328 inpatients using gabexate mesilate,22 cases(6.71%)were off-label and over-indication medication,all of them were surgical patients;94 cases(28.66%)were inappropriate solvents,93 cases used 0.9%sodium chloride injection as the solvent and 1 case used 10%dextrose injection as the solvent;7 cases(2.13%)were over-fast infusion speed,which was>2.5 mg/(kg·h);161 cases(49.09%)were combined application with ulinastatin.The combined application of ulinastatin and the different dosage regimens(≤5 d and>6 d)did not have significant effects on laboratory indicators,remission time of abdominal pain and length of hospital stay(P>0.05).CONCLUSIONS:The clinical application of gabexate mesylate is still inadequate,and the clinic should pay close attention to promote its rational application.