2017年遂宁市中心医院围手术期预防性应用注射用矛头蝮蛇血凝酶的合理性分析
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摘要
目的调查2017年遂宁市中心医院围手术期预防性应用注射用矛头蝮蛇血凝酶的情况,分析其应用合理性,促进合理用药。方法抽取遂宁市中心医院2017年1～12月围手术期使用注射用矛头蝮蛇血凝酶预防出血的手术病例3203例,分析注射用矛头蝮蛇血凝酶的合理应用情况。结果围手术期预防使用注射用矛头蝮蛇血凝酶的合理率为38.46%。3 203例病历中,存在选药不合理24例,用药时机不合理1447例,术后用药疗程长227例,用法用量不合理464例,不合理联合用药151例,其他不合理用药19例。结论遂宁市中心医院围手术期预防性应用注射用矛头蝮蛇血凝酶主要存在用药时机不合理、用法不合理、术后预防用药疗程长等不合理用药现象,应加强规范用药。
Objective To investigate the preventative application of Hemocoagulase Bothrops Atrox for injection during the perioperative period in Suining Central Hospital in 2017, and to analyze the rationality of its application to promote rational use of drugs. Methods 3 203 Cases of medical records with the use of Hemocoagulase Bothrops Atrox for injection during the perioperative period from January to December 2017 were selected in Suining Central Hospital in 2017, and its rational use situation was analyzed. Results The reasonable utilization rate of Hemocoagulase Bothrops Atrox for injection during the perioperative period was 38.46%. Among 3 203 cases of medical records, there were 24 cases in irrational drug selection, 1 447 cases in unreasonable medication time, 227 cases in long medication duration, 464 cases in improper usage and dosage, 151 cases in irrational combined medication, and 19 cases of other irrational drug use. Conclusion The irrational phenomena exist in the preventative application of Hemocoagulase Bothrops Atrox for injection during the perioperative period, which are mainly represented by the aspects of unreasonable medication time, improper usage, and dosage and long postoperative medication duration, which should be further standardized.
Objective To investigate the preventative application of Hemocoagulase Bothrops Atrox for injection during the perioperative period in Suining Central Hospital in 2017, and to analyze the rationality of its application to promote rational use of drugs. Methods 3 203 Cases of medical records with the use of Hemocoagulase Bothrops Atrox for injection during the perioperative period from January to December 2017 were selected in Suining Central Hospital in 2017, and its rational use situation was analyzed. Results The reasonable utilization rate of Hemocoagulase Bothrops Atrox for injection during the perioperative period was 38.46%. Among 3 203 cases of medical records, there were 24 cases in irrational drug selection, 1 447 cases in unreasonable medication time, 227 cases in long medication duration, 464 cases in improper usage and dosage, 151 cases in irrational combined medication, and 19 cases of other irrational drug use. Conclusion The irrational phenomena exist in the preventative application of Hemocoagulase Bothrops Atrox for injection during the perioperative period, which are mainly represented by the aspects of unreasonable medication time, improper usage, and dosage and long postoperative medication duration, which should be further standardized.
引文
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[6]Ramanan B,Gupta P K,Sundaram A,et al.In-hospital and postdischarge venous thromboembolism after vascular surgery[J].J Vasc Surg,2013,57(6):1589-1596.
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[8]Lindberg F,Bergqvist D,Rasnussen I.Incidence of thromboembolic complications after laparoscopic cholecystectomy review of the literature[J].Surg Laparosc Endosc,1997,7(4):324-331.
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[10]陈赫军,李洁,何芳,等.3种蛇毒类凝血酶制剂在外科手术的止血作用和经济学研究[J].中国医院药学杂志,2017,37(17):1735-1738.
[2]张石革,王汝龙.血液系统专家圆桌会议暨注射用血凝酶(巴曲亭)合理应用专家共识研讨会议纪要[J].中国医院用药评价与分析,2012,12(6):481-484.
[3]中华医学会神经外科学分会.神经外科围手术期出血防治的专家共识(2018)[J].中华医学杂志,2018,98(7):483-495.
[4]Wei J M,Zhu M W,Zhang Z T,et a1.A multicenter,phase III trial of hemocoagulase Agkistrodon:hemostasis,coagulation,and safety in patients undergoing abdominal surgery[J].Chin Med J(Engl),2010,123(5):589-593.
[5]杨智,王勇.老年患者围手术期止血药物的应用[J].山西医药杂志,2014,43(15):1830.
[6]Ramanan B,Gupta P K,Sundaram A,et al.In-hospital and postdischarge venous thromboembolism after vascular surgery[J].J Vasc Surg,2013,57(6):1589-1596.
[7]Ramot Y,Nyska A,Spectre G.Drug-induced thrombosis:an update[J].Drug Saf,2013,36(8):585-603.
[8]Lindberg F,Bergqvist D,Rasnussen I.Incidence of thromboembolic complications after laparoscopic cholecystectomy review of the literature[J].Surg Laparosc Endosc,1997,7(4):324-331.
[9]袁琳,邹小蓉,陈艳梅.注射用白眉蛇毒血凝酶的临床应用调查分析[J].药物流行病学杂志,2015,24(2):122-124.
[10]陈赫军,李洁,何芳,等.3种蛇毒类凝血酶制剂在外科手术的止血作用和经济学研究[J].中国医院药学杂志,2017,37(17):1735-1738.