某院围术期质子泵抑制剂预防应激性溃疡合理性评价

Rationality Evaluation of Proton Pump Inhibitors in the Prevention of Stress Ulcers During the Perioperative Period in a Hospital

目的评价医院外科患者围术期使用质子泵抑制剂(PPIs)预防应激性溃疡(SU)的合理性,为临床合理应用PPIs提供参考。方法随机抽取医院外科2022年10月至12月围术期预防性使用PPIs的出院患者的病历213份,统计患者的一般资料、手术情况、是否存在应激源、危险因素、PPIs的使用情况,根据指南并结合药品说明书评价PPIs使用的合理性。结果213例患者中,PPIs使用不合理229例次。其中,132例次(57.64%)无预防用药指征,50例次(21.84%)给药频次不适宜,23例次(10.04%)给药途径不适宜,16例次(6.99%)给药时机不适宜,8例次(3.49%)预防用药疗程偏长。结论外科患者围术期使用PPIs预防SU时,存在用药指征、给药频次、给用途径等不合理现象。医师、临床药师及医院质量管理部门需高度重视,应制订外科围术期PPIs预防SU的用药标准,规范围术期PPIs的使用。

Objective To evaluate the rationality of the use of proton pump inhibitors(PPIs)in the prevention of stress ulcers(SU)in surgical patients during the perioperative period in a hospital,and to provide a reference for the rational use of PPIs in the clinic.Methods A total of 213 medical records of discharged patients who received prophylactic use of PPIs during the perioperative period from October to December 2022 were randomly selected from the surgical department of the hospital.The general data of the patients,surgical status,existence of stressors,risk factors,and use of PPIs were collected and analyzed,and the rationality of the use of PPIs was evaluated according to guidelines and drug instructions.Results Among 213 patients,229 cases had irrational use of PPIs.Among them,132 cases(57.64%)had no indication for prophylactic medication,50 cases(21.84%)had inappropriate administration frequency,23 cases(10.04%)had inappropriate administration routes,16 cases(6.99%)had inappropriate administration timing,and 8 cases(3.49%)had a prolonged course of PPIs for prophylaxis.Conclusion When using PPIs to prevent SU in surgical patients during the perioperative period,there are unreasonable phenomena such as irrational medication indications,and administration frequency and administration routes.Clinicians,clinical pharmacists,and hospital quality management departments should attach great importance to it,establish medication standards of PPIs for the prevention of surgical patients with SU during the perioperative period,and standardize the use of PPIs during the perioperative period.