中药注射剂不合理用药医嘱帕累托图分析

Pareto Chart Analysis of Unreasonable Medical Prescriptions for Chinese Medicine Injection

目的 了解郑州市中医院(以下简称“本院”)中药注射剂的临床使用情况。方法 对郑州市中医院住院部2020年1月至2021年12月收治的1 317例应用中药注射剂的病历进行评价统计,采用帕累托图分析不合理用药的主要、次要及一般因素。结果 在1 317份使用中药注射剂的病历中,不合理病历共415份(占比31.51%),不合理用药频次为474次,不合理用药类型9种,其中主要因素是超剂量用药、稀释比例不适宜和适应证不适宜,构成比分别是31.01%(147频次)、30.17%(143频次)、10.55%(50频次);次要因素为未单独使用;一般因素为选择溶媒不适宜、超疗程用药、未冲管或冲管剂量不足、重复用药、给药途径不适宜。结论 依据帕累托图分析出的主要因素、次要因素、一般因素,医院可制订相应的干预措施加强中药注射剂在临床应用方面的管理,促进其合理用药。

Objective To understand the clinical use of Chinese medicine injections in Zhengzhou Hospital of Traditional Chinese Medicine(hereinafter referred to as"our hospital").Methods The medical records of 1317 cases applying herbal injections in our inpatient department between January 2020 and December 2021 were evaluated statistically,and the Pareto chart was used to analyze the major,minor and general factors of irrational drug use.Results Among the 1317 medical records of Chinese medicine injections,there were 415 irrational medical records(31.51%),474 irrational medication frequencies and 9 types of irrational medication,of which the main factors were overdose,inappropriate dilution ratio and inappropriate indications,with the composition ratios of 31.01%(147 frequencies),30.17%(143 frequencies)and 10.55%(50 frequencies),respectively.The secondary factors are not used alone;the general factors are inappropriate choice of solvents,over-therapeutic dosing,failure to flush the tube or insufficient dose of flush tube,repeated dosing,and inappropriate route of administration.Conclusion Based on the major,minor and general factors analyzed in the Pareto chart,hospitals can formulate corresponding interventions to strengthen the management of Chinese medicine injections in clinical application and promote their rational use.