2019-2021年蚌埠市第三人民医院胃内镜黏膜下剥离术围术期合理用药评价

Evaluation of rational drug use during perioperative period of gastric endoscopic submucosal dissection in Third People’s Hospital of Bengbu from 2019 to 2021

目的 探讨蚌埠市第三人民医院胃内镜黏膜下剥离术围术期用药情况,为临床合理用药提供参考。方法 选取蚌埠市第三人民医院2019年1月-2021年3月开展胃内镜黏膜下剥离术的所有出院病例,依据最新的共识、指南建立评价标准对围术期用药进行评价分析。结果 共抽取63份病例,围术期存在抑酸剂、抗菌药物及止血剂不合理用药现象,主要不合理用药问题为抑酸剂用药时机不适宜(30例,47.6%)、止血剂使用无指征(44例,69.8%)和预防使用抗菌药物的时机不适宜(47例,74.6%)。结论 针对蚌埠市第三人民医院胃内镜黏膜下剥离术围术期用药存在的问题,建议严格按照指南合理使用质子泵抑制剂,避免止血剂的滥用,抗菌药物的预防使用遵循《抗菌药物临床应用指导原则(2015版)》,严格术中无菌操作,把握预防使用抗菌药物的指征及预防使用的疗程,同时加大对临床内镜下胃黏膜剥离术围术期合理用药的宣教,以促进临床合理用药。

Objective To explore the perioperative medication of gastric endoscopic submucosal dissection in Third People’s Hospital of Bengbu, and to provide reference for clinical rational medication. Methods To select all discharged cases of gastric endoscopic submucosal dissection in Third People’s Hospital of Bengbu from January, 2019 to March, 2021, and establish evaluation criteria to evaluate and analyze perioperative medication according to the latest consensus and guidelines. Results A total of 63 cases were selected, and there were irrational drug use of antacids, antibiotics, and hemostatic agents during perioperative period. The main irrational drug use problems were inappropriate timing of antacids(30 cases, 47.6%), no indication of hemostatic agents(44 cases, 69.8%) and inappropriate timing of prophylactic use of antibiotics(47 cases, 74.6%). Conclusion In view of the problems existing in perioperative medication of gastric endoscopic submucosal dissection in Third People’s Hospital of Bengbu, it is suggested that proton pump inhibitors should be used reasonably in strict accordance with the guidelines to avoid the abuse of hemostatic agents, the prevention and use of antibiotics should follow the guiding principles of clinical application of antibiotics in 2015 edition, strict aseptic operation during operation, grasp the indications and treatment course of prevention and use of antibiotics, and at the same time, strengthen the publicity of perioperative rational medication of gastric endoscopic submucosal dissection to promote rational clinical medication.