住院患者糖皮质激素类药物专项点评分析与评价
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摘要
目的分析评价本院住院患者糖皮质激素类药物临床用药情况,使用趋势以及合理性趋势,并且对不合理用药情况进行总结分析,为临床合理用药及持续改进提供参考,提出2018年度工作重点及持续改进措施。方法 2017年度出院病历3382份每月全部抽取100%使用糖皮质激素类药物病历进行点评,共计点评153份,统计临床用药情况,并进行评价分析。结果2017年度第一季度医嘱合理率为94.44%,第二季度医嘱合理率为73.68%,第三季度医嘱合理率为90.63%,第四季度医嘱合理率为96.43%;不合理医嘱主要为医生开具医嘱在病程中无记录或用药分析和无适应症用药。结论住院患者糖皮质激素类药物医嘱合理率总体呈上升趋势,不合理用药的现象有所下降,体现持续改进。
Objective To analyze and evaluate of clinical drug use, using trend and the trend of rationality of glucocorticoid drugs in our hospital, and to provide a reference for clinical rational drug use and continuous improvement, and to put forward the emphasis of work and continuous improvement measures in 2018. Methods 3382 medical records of discharge in 2017 were collected from the medical records of 100% glucocorticoid drugs use per month for review, a total of 153 medical records were reviewed. The clinical drug use was evaluated and analyzed. Results The reasonable rate of doctors' prescription was 94.44% in the first quarter of 2017, 73.68% in the second quarter, 90.63% in the third quarter and 96.43% in the fourth quarter of 2017. Unreasonable doctors' prescription were mainly those without any record by doctors or analysis of medication and unindications in the course of the disease. Conclusion The rational rate of glucocorticoid medicine orders in inpatients is on the whole rising, and the phenomenon of irrational use is decreasing, which reflects continuous improvement in rational drug use.
Objective To analyze and evaluate of clinical drug use, using trend and the trend of rationality of glucocorticoid drugs in our hospital, and to provide a reference for clinical rational drug use and continuous improvement, and to put forward the emphasis of work and continuous improvement measures in 2018. Methods 3382 medical records of discharge in 2017 were collected from the medical records of 100% glucocorticoid drugs use per month for review, a total of 153 medical records were reviewed. The clinical drug use was evaluated and analyzed. Results The reasonable rate of doctors' prescription was 94.44% in the first quarter of 2017, 73.68% in the second quarter, 90.63% in the third quarter and 96.43% in the fourth quarter of 2017. Unreasonable doctors' prescription were mainly those without any record by doctors or analysis of medication and unindications in the course of the disease. Conclusion The rational rate of glucocorticoid medicine orders in inpatients is on the whole rising, and the phenomenon of irrational use is decreasing, which reflects continuous improvement in rational drug use.
引文
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[13]欧华,郁琦.阿司匹林、泼尼松及爱乐维联合用药在治疗不明原因早期复发性自然流产中的效果观察[J].中华医学杂志,2017,97(41):3250-3254.
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[15]陈雪容,潘琼委.自身免疫复发性流产治疗性探讨[J].中国医药科学,2016,6(18):85-87.
[16]Buckley L,Guyatt G.2017 American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis[J].Arthritis Rheumatol,201769(8):1521-1537.
[2]卫生部合理用药专家委员会,主编.中国医师药师临床用药指南[M].第2版.重庆:重庆出版社,2014,902-922.
[3]谢幸,主编.妇产科学[M].第八版.北京:人民卫生出版社,2013,58-61.
[4]Prevention and treatment of moderate and severe ovarian hyperstimulation syndrome a guideline[J].Fertil Steril,2016,106(7):1634-1647.
[5]American College of Obstetricians and Gunecologists,Committee Opinion No.713:Antenatal Corticosteroid Therapy for Fetal Maturation[J].Obstet Gynecol,2017,130(2):e102-e109.
[6]中华医学会妇产科学分会.早产的临床诊断与治疗指南[J].中华妇产科杂志,2014,49(7):481-484.
[7]张海萌,焦永慧.早产290例的临床分析[J].新疆医学,2014,44(9):51-53.
[8]豆媛媛,严卫丽.住院孕产妇的汉族、维吾尔族早产的相关因素研究[J].新疆医学,2014,44(7):19-22.
[9]Zhu Q,Wu L,Xu B,et al.A retrospective study on IVF/ICSI outcome in patients with anti-nuclear antibodies:the effects of prednisone plus low-dose aspirin adjuvant treatment[J].Reproductive Biology&Endocrinology,2013,11(1):98.
[10]Taiyeb AM,Ridha-Albarzanchi MT,Taiyeb SM,Kanan ZA,Alatrakchi SK,Kjelland ME,Muhsen-Alanssari SA.Improvement in pregnancy outcomes in couples with immunologically male infertility undergoing prednisolone treatment and conventional in vitro fertilization preceded by sperm penetration assay:a randomized controlled trial[J].Endocrine,2017,58(3):448-457.
[11]Siristatidis C,Dafopoulos K,El-Khayat W,Salamalekis G,Anifandis G,Vrantza T,Elsadek M,Papantoniou N.Administration of prednisolone and low molecular weight heparin in patients with repeated implantation failures:a cohort study[J].Gynecol Endocrinol,2018,34(2):136-139.
[12]贾研.中医辨证论治联合西药治疗抗磷脂综合征复发性流产临床研究[J].四川中医,2017(8):139-142.
[13]欧华,郁琦.阿司匹林、泼尼松及爱乐维联合用药在治疗不明原因早期复发性自然流产中的效果观察[J].中华医学杂志,2017,97(41):3250-3254.
[14]易秀娟.阿司匹林与强的松联合治疗抗心磷脂抗体阳性早孕复发性流产36例疗效观察[J].贵州医药,2014,38(6):527-528.
[15]陈雪容,潘琼委.自身免疫复发性流产治疗性探讨[J].中国医药科学,2016,6(18):85-87.
[16]Buckley L,Guyatt G.2017 American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis[J].Arthritis Rheumatol,201769(8):1521-1537.