脊柱融合术患者术后应激性溃疡预防用药的回顾性前后对照研究

Retrospective pre and post control study on prophylactic medication for postoperative stress ulcers in patients undergoing spinal fusion surgery

目的:临床药师通过制定应激性溃疡预防用药方案并实施药学干预,以减少预防应激性溃疡(stress ulcer prophylaxis,SUP)用药不合理率。方法:对2021—2022年首都医科大学宣武医院的骨科脊柱融合术患者进行了一项前后对照干预研究,比较临床药师实施SUP用药方案和药学干预前后的SUP不合理率、不良反应发生率、药品费用和药品使用时间等相关指标。结果:共纳入1567例骨科脊柱融合术患者,对照组778例患者,干预组789例患者。SUP总体合理率从20.69%提高到了54.87%,肺炎和腹泻不良反应发生率显著降低(2.96%vs.0.89%;5.66%vs.3.04%)(P<0.05)。干预后患者住院时间、抑酸药使用时间、西药费用显著降低(P<0.05)。结论:外科手术围术期SUP用药方案在脊柱融合术患者中取得了良好效果,能够显著减少临床应激性溃疡不合理预防用药,降低不适当的药品费用和不良反应的发生,保证患者用药安全。

OBJECTIVE Clinical pharmacists aim to reduce the irrational rate of Stress ulcer prophylaxis(SUP)by formulating a preventive medication plan and implementing pharmaceutical intervention.METHODS A pre-and post control intervention study was conducted for 1567 patients undergoing orthopedic spinal fusion surgery at Xuanwu Hospital from 2021 to 2022.They were assigned into two groups of intervention(n=789)and control(n=778).SUP unreasonable rate,adverse reaction rate,drug expense and drug dosing time were compared before and after implementing a SUP medication protocol by clinical pharmacists.RESULTS Overall reasonable rate of SUP spiked from 20.69%to 54.87%and the incidence of pneumonia and diarrhea declined markedly(2.96%vs 0.89%;5.66%vs.3.04%)(P<0.05).After intervention,length of hospital stay,duration of acid-inhibitor use and expense of western medicine dropped obviously(P<0.05).CONCLUSION SUP medication protocol during perioperative period has achieved decent outcomes in patients undergoing spinal fusion surgery.It can significantly lower unreasonable preventive medications for clinical stress ulcers,reduce inappropriate drug expenses,minimize adverse reactions and ensure medication safety.