某院2018年至2021年住院患者麻醉药品使用合理性分析

Rationality of Narcotic Drugs Used for the Inpatients in a Hospital from 2018 to 2021

目的 促进临床麻醉药品的合理使用。方法 调取医院信息系统中2018年1月至2021年12月某院住院患者麻醉药品的使用数据,包括药品的名称、规格、数量、使用金额,以2020年版《中国药典(二部)》《陈新谦新编药物学第18版》,药品说明书等确定限定日剂量(DDD),并计算用药频率(DDDs)、限定日费用(DDC)、使用金额排序与DDDs的排序比(B/A)。结果 4年间,该院住院患者使用麻醉药品共15个品规,5种剂型;使用金额总体呈增长趋势,枸橼酸舒芬太尼注射液(50μg)、盐酸瑞芬太尼注射液(1 mg)、注射用盐酸瑞芬太尼(2 mg)使用金额排前4名,分别呈平稳、升高、升高趋势,占4年总使用金额的87.88%,口服片剂的使用金额均排后2名;DDDs排序中,芬太尼透皮贴剂(5 mg)、枸橼酸舒芬太尼注射液(50μg)、盐酸瑞芬太尼注射液(1 mg)、注射用盐酸瑞芬太尼(2 mg)基本稳定于前4;DDC值均排前3名的为盐酸羟考酮注射液(10 mg)、枸橼酸舒芬太尼注射液(50μg)、盐酸瑞芬太尼注射液(1 mg),其中盐酸羟考酮注射液(10 mg)的使用金额、DDDs有明显波动但DDC较高;所有药品的B/A范围为0.38~5.00。结论 该院麻醉药品的临床使用基本合理,但其管理和使用仍存在问题,应继续加强对其使用的干预。

Objective To promote the rational use of narcotic drugs in the clinic.Methods The data such as drug name,specification,quantity and consumption sum of narcotic drugs used for inpatients in a hospital from January 2018 to December2021 in the hospital information system(HIS) were searched.The defined daily dose(DDD) was determined according to the Chinese Pharmacopoeia(Volume Ⅱ),the Chen Xinqian′s New Pharmacology(18th Edition),the drug instructions,etc.,and the DDDs,defined daily cost(DDC),the ratio of consumption sum ranking and DDDs ranking(B/A) were calculated.Results During the four years,the inpatients in the hospital used fifteen drug specifications and five dosage forms of narcotic drugs,the consumption sum of narcotic drugs showed an overall growth trend,and the use of Sufentanil Citrate Injection(50 μg),Remifentanil Hydrochloride Injection(1 mg) and Remifentanil Hydrochloride Injection(2 mg) ranked the top four,showing a steady,rising and rising trend respectively,accounting for 87.88% of the total consumption sum of narcotic drugs in the four years,while the consumption sum of oral tablets ranked the bottom two.In DDDs ranking,Fentanyl Transdermal Patch(5 mg),Sufentanil Citrate Injection(50 μg),Remifentanil Hydrochloride Injection(1 mg)and Remifentanil Hydrochloride Injection(2 mg)stably ranked in the top four.The DDC of Oxycodone Hydrochloride Injection(10 mg),Sufentanil Citrate Injection(50 μg) and Remifentanil Hydrochloride Injection(1 mg) ranked the top three,among which the consumption sum and DDDs of Oxycodone Hydrochloride Injection(10 mg) fluctuated significantly,but the DDC was higher.The B/A of all drugs was in the range of 0.38-5.00.Conclusion The clinical use of narcotic drugs in this hospital is reasonable,but there are still some problems in the management and use of narcotic drugs,and the intervention on the use of narcotic drugs should be strengthened.