3600例住院患者质子泵抑制剂应用合理性分析

摘要

目的:了解内江市第一人民医院(以下简称"我院")住院患者质子泵抑制剂(proton pump inhibitor,PPI)的合理使用情况,为临床合理用药提供参考.方法:从医院信息管理系统中随机抽取2016年4月—2017年4月我院全部临床科室使用PPI的3600例出院患者的病历资料,依据相关书籍、指南、文献及药品说明书等参考资料,对PPI的使用情况及合理性进行汇总分析.结果:3600例使用PPI的住院患者中,男性患者1880例,女性患者1720例;18～65岁患者1941例(占53.92％),>65岁患者1627例(占45.19％);多来自普外科和消化内科;除1例患者使用PPI的口服剂型外,其余患者均使用注射剂型,其中国产注射用兰索拉唑及国产注射用泮托拉唑钠的使用率较高.PPI不合理使用率为30.72％(1106/3600);其不合理应用主要表现为适应证不适宜(占50.99％,564/1106)、用法与用量不适宜(占39.51％,437/1106)及疗程偏长等.结论:我院住院患者PPI的使用存在多种不合理情况,主要为适应证不适宜、用法与用量不适宜.临床药师应加强干预,避免PPI的滥用,促进临床合理用药.%OBJECTIVE:To investigate the application rationality of proton pump inhibitor ( PPI) in inpatients from the First People's Hospital of Neijiang (hereinafter referred to as "our hospital"), so as to provide reference for the rational drug application in clinic .METHODS:Medical orders of 3600 inpatients with PPI from Apr .2016 to Apr. 2017 were randomly extracted from hospital information system , according to relevant books , guidelines , literatures and dispensatory , summary and analysis were conducted on application status and rationality of PPI .RESULTS:Of the 3600 inpatients with PPI , 1880 cases were males and 1729 cases were females .Patients aged 18-65 years old were 1941 cases (53.92％) , patients aged >65 were 1627 cases (45.19％);the inpatients with PPI were mainly from general surgery and digestive medicine; except for one patient with oral PPI , other patients were treated with injections , among which the application rate of domestic lansoprazole injection and pantoprazole sodium injection were relatively high .The irrational application rate of PPI was 30.72％ ( 1106/3600 ); the irrational application were mainly performed as improper indications ( 50.99％, 564/1106 ) , improper usage and dosage ( 39.51％, 437/1106) and long treatment course .CONCLUSIONS:There are still some irrational situations on application of PPI in our hospital , mainly performs as improper indications and improper usage and dosage .The clinical pharmacists should strengthen the intervention to avoid the abuse of PPI and promote the rational drug application in clinic .