解放军第一八〇医院2014―2016年神经营养类辅助用药的应用分析

摘要

Objective: To provide reference for rational use of neurotrophic adjuvant drugs in clinic. Methods: The sales, DDDs, DDC, sorting ratio (B/A), and departments using neurotrophic adjuvant drugs in our hospital from 2014 to 2016 were extracted from the hospital information system (HIS), and statistical analysis was made. Results: In 2016, the total sales of neurotrophic adjuvant drugs was 22 602 800 yuan, which was obviously lower than that of 28 409 600 yuan in 2015. However, the total DDDs increased from 121 588.58 to 145 062.08 during 2014―2016. Overall, the amount ratios of monosialotetrahexosylganglioside sodium injection, mouse nerve factor injection (18 μg), alprostadil injection (10 μg), deproteinized calf blood extractives frozen powder for injection, cinepazide maleate injection (320 mg) and cattle encephalon glycoside and ignotin injection were still rising in the last 3 years. In addition to cerebroprotein hydrolysate frozen powder for injection and oxiracetam frozen powder for injection, the B/A of all the other drugs ranged from 0.5 to 1.5 in the last 3 years and the synchronization was better. In 2016, the DDCs of cattle encephalon glycoside and ignotin injection rose to the first place and its utilization rate in the department of neurology ranked the first for 3 years. The second department of orthopedics, the department of neurology and the first department of orthopedics were the top three departments for the amount ratio of cattle encephalon glycoside and ignotin injection in 2016. Conclusion: Based on the spectrum of diseases and the characteristics of drugs, the application of neurotrophic adjuvant drugs in our hospital is rational on the whole, meanwhile, the hospital should strengthen supervision and standardize medication behaviors so as to avoid the risk of irrational medication.%目的:为临床合理使用神经营养类辅助用药提供参考.方法:应用医院信息系统(HIS),提取、统计和分析解放军第一八〇医院2014—2016年神经营养类辅助用药的销售金额、用药频度(DDDs)、日均费用(DDC)、排序比(B/A)以及各科室使用情况.结果:2016年神经营养类辅助用药销售总金额为2260.28万元,较2015年的2840.96万元明显下降.而2014—2016年DDDs总量由121588.58上升至145062.08,且单唾液酸四己糖神经节苷脂钠注射剂、鼠神经生长因子注射剂(18 μg)、前列地尔注射液(10 μg)、小牛血去蛋白提取物冻干粉、马来酸桂哌齐特注射液(320 mg)和脑苷肌肽注射液6种神经营养类辅助用药的金额比近3年总体仍呈上升趋势.除脑蛋白水解物冻干粉和奥拉西坦粉针剂外,其他药品连续3年的B/A均在0.5~1.5,同步性较好.2016年脑苷肌肽注射液DDC排名升至第1位,该药连续3年使用率排名第1位的科室是神经内科,2016年该药销售金额比排名前3位的科室分别为骨科二区、神经内科和骨科一区.结论:结合各科室的疾病谱以及各种药品的特点,神经营养类辅助用药的使用总体较为合理,但仍需加强监管,规范临床使用,规避用药风险.