胃肠道手术患者使用质子泵抑制剂的合理性评价

Rationality Evaluation of Proton Pump Inhibitors in Patients Receiving Gastrointestinal Surgery

关键词:  质子泵抑制剂|胃肠道手术|合理用药

Key words:  proton pump inhibitors|gastrointestinal surgery|rational use of drug

摘要:

目的 分析胃肠道手术患者围手术期使用质子泵抑制剂的情况，为促进质子泵抑制剂的合理使用提供参考。方法 采用回顾性调查研究的方法，收集2017年7月-2018年6月使用质子泵抑制剂的胃肠道手术病例信息，对质子泵抑制剂的使用率、药物品种及使用情况、用药指征进行统计分析与评价，然后对有用药指征病例的药物选择、用药时机、用法用量等进行评价。结果 857例肠道手术病例中使用质子泵抑制剂的有457例，使用率达53.33%；313例（65.49%）无指征用药；144例有指征用药的病例还存在用药时机和每日频次不合理、用药疗程过长的情况，其中用药时机合理的有41例、给药频次合理的有31例、用药疗程合理的有116例；有指征用药，且用药时机、给药频次、用药疗程均合理的有19例。结论 临床医师对胃肠道手术围手术期质子泵抑制剂使用指征的判断能力需要加强。药师应用两步法进行药物使用合理性评价，能准确快速把握评价方式方法，提高工作质量和工作效率。

Abstract:

OBJECTIVE To analyze the usage of proton pump inhibitors in patients receiving gastrointestinal surgery, so as to provide reference for promoting rational use of drug. METHODS The cases receiving gastrointestinal surgery and using proton pump inhibitors were collected from July 2017-June 2018, the utilization rate of proton pump inhibitors, drug varieties and usage, and medication indications were statistically analyzed and evaluated, and then the drug selection, medication timing, usage and dosage of cases with medication indications were evaluated. RESULTS There were 457 cases using proton pump inhibitors in 857 cases receiving gastrointestinal surgery, and the utilization rate was 53.33%, 313 cases(65.49%) had no indications. There were some problems involve unreasonable medication time, unreasonable medication frequency and long course of treatment in 144 cases with indications, and there were 41 cases with reasonable medication time, 31 cases with reasonable medication frequency and 116 cases with reasonable course of treatment. There were 19 cases with indications and reasonable medication time, frequency, course of treatment. CONCLUSION Clinicians need to strengthen their ability to judge the indications for the use of proton pump inhibitors during perioperative period of gastrointestinal surgery. Pharmacists use two-step method to evaluate the rationality of drug use, which can accurately and quickly use the evaluation methods and improve the quality and efficiency of work.