我院注射用质子泵抑制剂不合理使用情况分析

Analysis of irrational use of proton pump inhibitors for injection in our hospital

目的回顾性调查德州市德城区中医医院住院患者注射用质子泵抑制剂(PPIs)使用情况,以促进本院临床合理规范应用质子泵抑制剂。方法采用回顾性分析,调取本院使用注射用质子泵抑制剂治疗的1260例住院患者的临床资料,分析本院注射用质子泵抑制剂的合理性。结果本院共有3个品种注射用质子泵抑制剂,分别是注射用奥美拉唑钠、注射用兰索拉唑钠、注射用泮托拉唑钠。1260份病历中,年龄<18岁11份(0.87%),年龄在18~65岁519份(41.19%),年龄>65岁730份(57.94%);男性623份(49.44%),女性637份(50.56%)。治疗用药187份(14.84%),预防用药1073份(85.16%);合理用药646份(51.27%),不合理用药614份(48.73%),不合理用药涉及11个科室,重症加强护理病房(ICU)7份、脑病一科81份、脑病二科50份、脑病三科11份、普外科75份、骨伤科45份、感染科8份、耳鼻喉科3份、内科178份、内三科59份、心内科97份。不合理用药614份,其类型主要包括4方面,无适应证用药不合理376份(61.24%),用法用量不合理95份(15.47%),联合用药不合理19份(3.09%),超疗程用药不合理124份(20.20%)。结论本院注射用质子泵抑制剂临床使用存在不合理情况,为确保患者合理用药,本院将加强处方干预、用药宣讲等措施提升临床合理用药,避免发生药物不良反应以及合理控制医疗费用。

Objective To retrospectively investigate the use of proton pump inhibitors(PPIs)for injection in hospitalized patients in Dezhou Decheng District Hospital of Traditional Chinese Medicine,and to promote the rational and standardized use of proton pump inhibitors in our hospital.Methods The clinical data of 1260 patients treated with proton pump inhibitor for injection in our hospital were retrospectively analyzed to analyze the rationality of proton pump inhibitors for injection in our hospital.Results There were three types of proton pump inhibitors for injection in our hospital,namely omeprazole sodium for injection,lansoprazole sodium for injection and pantoprazole sodium for injection.Of the 1260 medical records,11 patients(0.87%)aged<18 years,519 patients(41.19%)aged 18-65 years,and 730 patients(57.94%)aged>65 years;there were 623 males(49.44%)and 637 females(50.56%).There were 187 records(14.84%)of therapeutic medication and 1073 records(85.16%)of preventive medication;614records were irrational medication(48.73%)and 646records were rational medication(51.27%).Irrational drug use involved 11 departments,including 7 records in intensive care unit(ICU),81 records in first department of encephalopathy,50 records in second department of encephalopathy,11 records in third department of encephalopathy,75 records in department of general surgery,45 records in department of orthopaedics,8 records in department of infection,3 records in ear-nose-throat department,178 records in department of internal medicine,59 records in third department of internal medicine and 97 records in department of cardiology.There were 614 records of irrational drug use,which mainly included 4 types:irrational drug use without indications in 376 records(61.24%),irrational usage and dosage in 95 records(15.47%),irrational combined drug use in 19 records(3.09%),and irrational drug use over a course of treatment in 124 records(20.20%).Conclusion The clinical use of proton pump inhibitors in our hospital is irrational.In order to ensure rational drug use,our hospital will strengthen prescription intervention,medication publicity and other measures to improve clinical rational drug use,avoid adverse drug reactions and reasonable control of medical costs.