236例巴曲酶注射液治疗血管闭塞性疾病的警示医嘱用药分析

Medication of Warning Medical Orders in 236 Cases of Batroxobin Injection in the Treatment of Vascular Occlusive Diseases

目的:回顾性分析巴曲酶注射液用于治疗血管闭塞性疾病的警示医嘱,为临床合理使用巴曲酶注射液提供参考。方法:基于PASS医嘱审核结果数据库,导出2020年9月至2023年6月河北省人民医院巴曲酶注射液所有警示级别的医嘱236例,进行统计分析。利用Excel软件辅助作图,计数资料采用频数及百分比描述,计量资料采用分段描述频数和百分比描述。结果:236例巴曲酶注射液治疗血管闭塞性疾病的警示医嘱中,男性患者(136例)、中老年患者(≥60岁,164例)居多;警示医嘱出现最多的科室是血管外科;警示级别中,橙灯问题占25.85%(61例),红灯问题占16.10%(38例),黑灯问题占58.05%(137例),黑灯警示医嘱均因为药物的相互作用。结论:男性、高龄是血管闭塞性疾病的高危因素;医嘱中存在禁忌证、超适应证、超频次及不符合维持剂量范围使用巴曲酶注射液的问题;同属纤维蛋白原溶解药以及巴曲酶注射液与阿司匹林的联合应用,并非绝对的禁忌,在控制好药物剂量、监测凝血-纤溶指标的前提下,上述药物联合应用可以进一步改善患者的临床结局。

OBJECTIVE:To retrospectively analyze the warning medical orders of batroxobin injection in the treatment of vascular occlusive diseases,so as to provide reference for the clinical rational application of batroxobin injection.METHODS:Based on the PASS medical order review result database,236 cases in warning-level medical orders of batroxobin injection in Hebei General Hospital from Sept.2020 to Jun.2023 were derived to be statistically analyzed.Excel software was used to assist in graphing,enumeration data was described by frequency and percentage,and measurement data was described by segmental description of frequency and percentage.RESULTS:Among the 236 cases of warning medical orders of batroxobin injection in the treatment of vascular occlusive diseases,male patients(136 cases)and middle-aged and elderly patients(≥60 years,164 cases)were predominant;the clinical department with the most frequent warning medical orders was vascular surgery department.In terms of the warning levels,orange-light problems accounted for 25.85%(61 cases),red-light problems accounted for 16.10%(38 cases)and black-light problems accounted for 58.05%(137 cases),the black-light warning medical orders were because of drug interactions.CONCLUSIONS:Male and the elderly are the high-risk factors for vascular occlusive diseases.There are problems including contraindications,off-label indications,off-label frequency and non-compliance with maintenance dose range in the application of batroxobin injection in medical orders.Combination application of congeneric fibrinogenolytic drugs and batroxobin injection with aspirin are not absolute contraindications,while the above combined application can further improve the clinical outcomes of patients under the premise of controlled drug dosage and monitored coagulation-fibrinolytic indexes.