泌尿外科围手术期预防用质子泵抑制剂的调查分析

Retrospective investigation and analysis of proton pump inhibitors for perioperative prophylaxis in the department of urology

目的 回顾性调查分析南通市第一人民医院泌尿外科围手术期预防用质子泵抑制剂(PPIs)的使用情况,以期为下阶段提高PPIs的合理使用提供理论依据。方法 回顾性分析2022年1月~6月南通市第一人民医院泌尿外科每月第1周出院且病程中行手术的148例患者的病历资料,分析PPIs预防使用率、使用品种、预防用药合理性以及药品金额等。结果 共纳入148份病例,质子泵抑制剂的预防用药率99.32%(147/148),其中无预防指征用药率为84.35%(124/147)。在品种上以奥美拉唑(53.74%)和雷贝拉唑(42.18%)为主,且均采用静脉给药方式。在用法上PPIs多为手术后开始给药(91.16%,134/147),平均用药疗程为1.28 d。在金额上PPIs总费用占所有药品总费用的2.93%,其中PPIs费用中有86.15%属无指征用药支出。结论 泌尿外科围手术期预防用PPIs无指征用药率高,在PPIs品种选择、给药时机等合理用药方面还有待改进,下阶段应加强药学干预,规范临床使用。

Objective To retrospectively investigate and analyze the proton pump preparations(PPIs)for perioperative prophylaxis in the Urology Department of the First People’s Hospital of Nantong,in order to provide reference and basis for improving the rational use of PPIs in the next stage.Methods Retrospective analysis was made on the medical records of 148 patients discharged from the urology department of the First People’s Hospital of Nantong in the first week of each month and operated during the course of their illness from January to June 2022.The utilization rate,varieties,rationality of prophylactic drugs and drug amount of PPIs were analyzed.Results A total of 148 cases were included,and the proton pump inhibitor prophylactic use rate was 99.32%(147/148).Among them,84.35%(124/147)had no indication of prevention.In terms of varieties,omeprazole(53.74%)and rabeprazole(42.18%)were the main ones,and all of them were administered intravenously.The time of administration of PPIs was mostly postoperative administration(91.16%,134/147),and the average duration of administration was 1.28 days.The total cost of PPIs accounted for 2.93%of the total drug cost,of which 86.15%of the total cost of PPIs belonged to non-indicative drug expenses.Conclusion The rate of unindicated prophylactic PPIs was high for perioperative prophylaxis in the department of urology in the First People’s Hospital of Nantong.There were still some improvement in the rational use of PPIs,such as selection of varieties and timing of administration.In the next stage,pharmaceutical intervention should be strengthened to standardize clinical use.