2017—2020年某三级甲等医院住院患者麻醉药品应用情况分析

Use of narcotics for inpatients in a tertiary hospital,2017-2020

目的分析西安市人民医院住院患者麻醉药品的使用情况、用药趋势及存在的问题,促进麻醉药品的管理和合理使用。方法调取医院信息系统(HIS)中2017年1月至2020年12月住院患者麻醉药品处方的用药数据,对使用科室分布、药品品种、销售金额、用药频度(DDDs)、限定日费用(DDC)、药物利用指数(DUI)及排序比(B/A)等进行统计分析。结果该三级甲等医院住院患者使用的麻醉药品共9个品种(其中注射剂型7种,口服剂型1种、外用剂型1种),麻醉药品的销售金额及药品销售占比呈逐年上升趋势,麻醉药品的使用主要分布在麻醉科、外科、妇产科。销售金额及DDDs居前2位的是注射用瑞芬太尼和舒芬太尼注射液。氢吗啡酮注射液自2018年销售后使用量大幅度提升,销售金额及DDDs一直居第3位。羟考酮注射液的用量及销售金额逐年下降。DDC居前2位的分别是羟考酮注射液、注射用瑞芬太尼、氢吗啡酮注射液以及舒芬太尼注射液。吗啡缓释片自2018年后DUI值>1,其他多数麻醉药品的DUI值≤1。氢吗啡酮注射液、芬太尼注射液、吗啡注射液及吗啡缓释片各年B/A值均等于或接近1。结论该院麻醉药品销售金额逐年增加,用药合理性和规范性基本符合相关要求,在今后的工作中仍需继续加强麻醉药品的管理和使用。

Objective To investigate the narcotics use,trends in the prescription and potential improper practice for inpatients in Xi′an people′s hospital,in hope of enhancing the stewardship and rational use of narcotic agents.Methods The medication data of narcotics prescribed to inpatients between January 2017 and December 2020 were retrieved from the hospital information system(HIS).Statistics on the distribution of medicating depart-ments,categories,total sales,defined daily dose(DDD),defined daily cost(DDC),drug utilization index(DUI)and the ratio of total sales ranking to DDD ranking(B/A ratio)of the narcotics were analyzed.Results There were 9 categories of narcotics prescribed to inpatients in this tertiary hospital,including 7 for injection,1 for oral use and 1 for topical administration.The absolute and percentage amount of total narcotic showed an increasing trend year on year.The narcotics were predominately prescribed by departments of anesthesiology,surgery,and obstetrics and gynecology.The first two narcotics leading the rankings of sales amount and DDDs were injectable Remifen-tanil and sufentanil injection.There was a substantial rise in the use of hydromorphone injection since its availa-bility in 2018,which stably result in its third position in rankings of sales amount and DDDs.The use and sales amount of oxycodone injection were noted to decline year by year.The first four narcotics that lead the DDC ranking were oxycodone injection,injectable remifentanil,hydromorphone injection,and sufentanil injection.Since 2018,the DUIs were no more than 1.0 for all narcotics except the sustained-release morphine tablets.The annual B/A ratios of hydromorphone injection,fentanyl injection,morphine injection and sustained-release morphine tablets were all equal or close to 1.0.Conclusion In the surveyed hospital,the sales amount of narcotics remains on the rise year by year.The narcotics use is largely rational and normative according to relevant requirements,yet more efforts are still needed to enhance the stewardship and stipulation on narcotics use in the future.