外科术后应用非甾体抗炎药注射剂情况分析

Analysis of the Application of Non-steroidal Anti-inflammatory Injection After Surgery

关键词:  非甾体抗炎药  注射剂  医嘱审核  合理用药  合理性评价

Key words:  non-steroidal anti-inflammatory drug  injection  medical order examination  rational drug use  rationality evaluation

摘要:

目的 评价某三乙医院非甾体抗炎药注射剂在外科术后镇痛的应用情况，并分析其应用合理性。方法 利用该院的电子病例等HIS系统、合理用药软件，抽取2018年1月—12月术后使用非甾体抗炎药注射剂的住院电子病例3 905份进行回顾性点评。结果 该院术后使用非甾体抗炎药注射剂的患者共有3 905例，集中于手足外科、骨科、泌尿外科等科室，其中不合理病例1 406份（36.01%），27例（0.69%）出现不良反应。不合理用药主要表现为用法用量不适宜（1 375例，35.21%）、联合用药不适宜（179例，4.58%）、选药不适宜（48例，1.23%）、超说明书用药（8例，0.20%）。该院外科术后应用非甾体抗炎药注射剂存在不合理情况，85.28%的不合理病例为用法用量中的给药方式选择静脉滴注。结论 该院术后非甾体抗炎药注射剂合理使用有较大改进空间，术后使用非甾体抗炎药应严格依据药品说明书用药。医院应及时向临床传递合理用药信息，开展合理用药宣教，借助信息化手段管控非甾体抗炎药注射剂的用法用量等，采取多方面措施保障患者术后用药安全，促进患者术后快速康复。

Abstract:

OBJECTIVE To evaluate the application of non-steroidal anti-inflammatory drugs(NSAID) in a Grade III B hospital in postoperative analgesia and analyze its rationality. METHODS Using the electronic case and other HIS system and rational drug use software, 3 905 inpatients who received NSAIDs after operation from January to December 2018 were selected for retrospective evaluation. RESULTS A total of 3 905 patients were treated with NSAIDs after operation, including 1 406 cases of unreasonable cases and 27 cases of adverse reactions, which were mainly in the departments of hand and foot surgery, orthopedics and urology. The main manifestations of irrational use of drugs were inappropriate dosage and Drug delivery mode (1 375 cases, 35.21%), combined use (179 cases, 4.58%) and improper drug selection (48 cases, 1.23%), overprescriptive medication (8 cases, 0.20%). The use of NSAIDs was unreasonable after surgery in this hospital, 85.28% of the unreasonable cases were selected for intravenous drip in the mode of administration. CONCLUSION Clinicians should strictly follow the drug instructions, in addition, hospitals should timely transmit rational drug use information to clinicians, carry out rational drug use education, control the usage of non-steroidal anti-inflammatory injection by means of information technology, etc. Various measures should be taken to ensure the safe use of drugs and to promote the rapid recovery of postoperative patients.