浅议临床基础用药诸指南内容冲突的解决之道
|
摘要
针对增强CT碘海醇、碘普罗胺碘造影剂是否应用药预防过敏性休克、以及脑出血活动期患者是否使用甘露醇脱水降颅压等问题,《临床用药须知》与《临床诊疗指南》的规定完全相反。文章提出建立《临床用药须知》国家标准的主导地位以及开展药物临床诊疗指南冲突再评价等措施,解决临床基础用药指南内容冲突,并将冲突内容向患者知情告知的观点。
In view of the problems of whether to use iohexol, iopromide iodine-contrast agent in enhanced CT to prevent anaphylactic shock and whether to use mannitol dehydration to reduce cranial pressure in patients with active cerebral hemorrhage, the regulations in Clinical Medication Guidelines are completely contrary to those in Clinical Diagnosis and Treatment Guidelines. This paper puts forward the ideas of establishing the leading position of national standard for Clinical Medication Guidelines, carrying out the reevaluation of the conflict of clinical medication guidelines, solving the conflict of clinical basic medication guidelines and informing patients of the conflict.
In view of the problems of whether to use iohexol, iopromide iodine-contrast agent in enhanced CT to prevent anaphylactic shock and whether to use mannitol dehydration to reduce cranial pressure in patients with active cerebral hemorrhage, the regulations in Clinical Medication Guidelines are completely contrary to those in Clinical Diagnosis and Treatment Guidelines. This paper puts forward the ideas of establishing the leading position of national standard for Clinical Medication Guidelines, carrying out the reevaluation of the conflict of clinical medication guidelines, solving the conflict of clinical basic medication guidelines and informing patients of the conflict.
引文
[1]张峰,范贞.规范临床用药指南一致性,减少药物不良反应导致的医疗纠纷[J].中国医院,2016,20(10):40-42.
[2]国家药典委员会.中华人民共和国药典临床用药须知(化学药和生物制品卷,2015年版)[M].北京:中国医药科技出版社,2017.
[3]周纯武.放射科诊疗常规[M].北京:中国医药科技出版社,2012:27.
[4]中华医学会放射学分会、中国医师协会放射医师分会.对比剂使用指南(第1版)[J].中华放射学杂志,2008,42(3):320-325.
[5]中华医学会.临床诊疗指南(放射学检查技术分册)[M].北京:人民卫生出版社,2009:181.
[6]江甲子,刘志.急诊患者常用碘造影剂致过敏性休克155例分析[J].中国现代药物应用,2014,807:172-173.
[7]佚名.国家食品药品监督管理总局提醒关注碘普罗胺注射液的严重过敏反应[J].药物评价研究,2013,36(02):131.
[8]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国脑出血诊治指南(2014)[J].中华神经科杂志,2015,48(6):435-444.
[9]Candice Delcourt,Maree Hackett,Yanfeng Wu,et al. Determinants of Quality of Life After Stroke in China:The ChinaQUEST(QUality Evaluation of Stroke care and Treatment)Study[J].Stroke. 2011(42):433-438.
[2]国家药典委员会.中华人民共和国药典临床用药须知(化学药和生物制品卷,2015年版)[M].北京:中国医药科技出版社,2017.
[3]周纯武.放射科诊疗常规[M].北京:中国医药科技出版社,2012:27.
[4]中华医学会放射学分会、中国医师协会放射医师分会.对比剂使用指南(第1版)[J].中华放射学杂志,2008,42(3):320-325.
[5]中华医学会.临床诊疗指南(放射学检查技术分册)[M].北京:人民卫生出版社,2009:181.
[6]江甲子,刘志.急诊患者常用碘造影剂致过敏性休克155例分析[J].中国现代药物应用,2014,807:172-173.
[7]佚名.国家食品药品监督管理总局提醒关注碘普罗胺注射液的严重过敏反应[J].药物评价研究,2013,36(02):131.
[8]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国脑出血诊治指南(2014)[J].中华神经科杂志,2015,48(6):435-444.
[9]Candice Delcourt,Maree Hackett,Yanfeng Wu,et al. Determinants of Quality of Life After Stroke in China:The ChinaQUEST(QUality Evaluation of Stroke care and Treatment)Study[J].Stroke. 2011(42):433-438.