注射用紫杉醇(白蛋白结合型)临床应用合理性分析

Clinical Application Rationality of Paclitaxel Injection (Albumin-Bound)

目的:探讨注射用紫杉醇(白蛋白结合型)在苏州市中医医院用于恶性肿瘤的临床使用合理性,为临床合理用药提供参考。方法:采用回顾性调查分析,通过医院信息系统汇总2022年1月1日至2024年1月1日苏州市中医医院使用注射用紫杉醇(白蛋白结合型)患者的用药特征信息,评价用药合理性。结果:共106例患者使用注射用紫杉醇(白蛋白结合型)840例次,396例次存在不合理,不合理率为47.14%,主要表现为无循证医学证据的超适应证用药(98例次,发生率为11.67%)、用法与用量不合理(207例次,发生率为24.64%)、联合用药不合理(2例次,发生率为0.24%)及止吐预处理不合理(346例次,发生率为41.19%);常见的不良反应为疲劳乏力、血液毒性、周围神经毒性等,发生率分别为66.67%(560例次)、45.60%(383例次)、12.14%(102例次)。结论:注射用紫杉醇(白蛋白结合型)被广泛用于多种恶性肿瘤的治疗,临床应用不合理现象较普遍,需要引起临床重视,药师需做好药学监护,保障用药安全。

OBJECTIVE:To probe into the clinical application rationality of paclitaxel injection(albumin-bound)in the treatment of malignant tumors in Suzhou Hospital of Traditional Chinese Medicine,so as to provide reference for clinical rational medication.METHODS:Retrospective investigation and analysis were adopted to evaluate the rationality of medication by summarizing information on the medication characteristics of patients receiving paclitaxel injection(albumin-bound)in the hospital Suzhou Hospital of Traditional Chinese Medicine from Jan.1st 2022 to Jan.1st 2024 through the hospital information system.RESULTS:A total of 106 patients received paclitaxel injection(albumin-bound)in 840 cases,and there were 396 cases of irrationality,with an irrationality rate of 47.14%,which mainly manifested in off-label indication of medication without evidence of evidence-based medicine(98 cases,11.67%),improper usage and dosage(207 cases,24.64%),unreasonable drug combination(2 cases,0.24%)and improper antiemetic pretreatment(346 cases,41.19%).Common adverse drug reactions were fatigue and weakness,hematotoxicity and peripheral neurotoxicity,with incidences of 66.67%(560 cases),45.60%(383 cases)and 12.14%(102 cases),respectively.CONCLUSIONS:Paclitaxel injection(albumin-bound)is widely used in the treatment of various malignant tumours,and the phenomenon of irrational clinical application is common,which needs to attract clinical attention,and pharmacists need to do a good job of pharmacological supervision to ensure medication safety.