2018年1～4月福州总医院儿科门诊雾化药的使用情况分析
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摘要
目的调查分析福州总医院儿科门诊雾化药的应用情况,为其临床合理应用提供参考。方法提取2018年1～4月儿科门诊雾化药物的应用数量;并调阅2018年1～4月儿科门诊应用雾化药物的处方总共1 267张,对患儿年龄,雾化药的联合情况、医师诊断及其合理性等进行统计分析。结果儿科门诊常用雾化药物有糖皮质激素、短效β2受体激动剂、黏液溶解剂、M胆碱受体阻断剂和抗病毒药物,其中糖皮质激素、短效β2受体激动剂应用数量远大于其他雾化药;1267张处方中雾化药种类单独应用占28.49%,联合应用占71.51%;应用于多种呼吸道感染、支气管炎、肺炎、哮喘、扁桃体炎、咳嗽等多达30类临床诊断。不合理处方占全部处方的52.96%,主要为不明确处方,占38.67%。结论福州总医院儿科门诊雾化药的应用存在一定的不合理情况,医院和儿科医生应该给予足够的重视,以确保临床用药的合理性。
Objective To investigate and analyze the application of atomized drugs in Pediatric Clinic of Fuzhou General Hospital in 2018, so as to provide references for their rational use in clinic. Methods The applied amount of atomized drugs used in Pediatric Clinic from January to April in 2018 was extracted, and 1 267 outpatient prescriptions were selected from Pediatric Clinic from January to April in 2018. Age, combination of atomized drugs, clinical diagnosis, and rationality were analyzed statistically. Results The commonly used atomized drugs in Pediatric Clinic were glucocorticoids, short-acting β2 receptor agonists, mucous dissolving agent, M cholinergic blockers, and antiviral drugs, and the using number of glucocorticoids and short-acting β2 receptor agonists were much greater than other atomized drugs. Among the 1 267 prescriptions reviewed, 28.49% was applied alone and 71.51% was applied with joint. These atomized drugs which were applied to treat 30 kinds of diseases including various types of respiratory infections, bronchitis, pneumonia, asthma, tonsillitis, and cough, etc. Unreasonable prescription accounted for 52.96%, and most of them were mainly was indefinite prescription(38.67%). Conclusion There is some unreasonable drug use of atomized drugs in Pediatric Clinic of Fuzhou General Hospital. Hospitals and pediatricians should give enough attention and make improvements to ensure the rationality of clinical medication.
Objective To investigate and analyze the application of atomized drugs in Pediatric Clinic of Fuzhou General Hospital in 2018, so as to provide references for their rational use in clinic. Methods The applied amount of atomized drugs used in Pediatric Clinic from January to April in 2018 was extracted, and 1 267 outpatient prescriptions were selected from Pediatric Clinic from January to April in 2018. Age, combination of atomized drugs, clinical diagnosis, and rationality were analyzed statistically. Results The commonly used atomized drugs in Pediatric Clinic were glucocorticoids, short-acting β2 receptor agonists, mucous dissolving agent, M cholinergic blockers, and antiviral drugs, and the using number of glucocorticoids and short-acting β2 receptor agonists were much greater than other atomized drugs. Among the 1 267 prescriptions reviewed, 28.49% was applied alone and 71.51% was applied with joint. These atomized drugs which were applied to treat 30 kinds of diseases including various types of respiratory infections, bronchitis, pneumonia, asthma, tonsillitis, and cough, etc. Unreasonable prescription accounted for 52.96%, and most of them were mainly was indefinite prescription(38.67%). Conclusion There is some unreasonable drug use of atomized drugs in Pediatric Clinic of Fuzhou General Hospital. Hospitals and pediatricians should give enough attention and make improvements to ensure the rationality of clinical medication.
引文
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[14]尚云晓,黄英,刘恩梅,等.雾化吸入重组人干扰素α1b治疗小儿急性毛细支气管炎多中心研究[J].中国实用儿科学,2014,29(11):840-844.
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[17]李明华,段楷生,蔡映云.哮喘病学[M].第2版.北京:人民卫生出版社,2005:286-295.
[2]中华医学会儿科学分会呼吸学组.儿童支气管哮喘诊断与防治指南(2016年版)[J].中华儿科杂志,2016,54(3):167-181.
[3]中华医学会呼吸病学分会《雾化吸入疗法在呼吸疾病中的应用专家共识》制定专家组.雾化吸入疗法在呼吸疾病中的应用专家共识[J].中华医学杂志,2016,96(34):2696-2708.
[4]申昆玲,邓力,李云珠,等.糖皮质激素雾化吸入疗法在儿科应用的专家共识(2018年修订版)[J].临床儿科杂志,2018,36(2):95-107.
[5]Dahlberg E,Thalén A,Brattsand R,et al.Correlation between chemical structure,receptor binding,and biological activity of some novel,highly active,16 alpha,17 alphaacetal-substituted glucocorticoids[J].Mol Pharmacol,1984,25(1):70-78.
[6]Brattsand R,Miller-Larsson A.The role of intracellular esterification in budesonide once-daily dosing and airway selectivity[J].Chin Ther,2003,25(Suppl C):C28-C41.
[7]Miller-Larsson A,Jasnsson P,Runstrom A,et al.Prolonged airway activity and improved selectivity of budesonide possibly due to esterification[J].Am J Respir Crit Care Med,2000,162(4 pt 1):1455-1461.
[8]Edsb?cker S,Johansson C J.Airway selectivity:an update of pharmacokinetic factors affecting local and systemic disposition of inhaled steroids[J].Basic Clin Pharmacol Toxicol,2006,98(6):523-536.
[9]卞如濂,唐发娣.呼吸病理学新论[M].北京:人民卫生出版社,2004.
[10]Cave A,Arlett P,Lee E.Inhaled and nasal corticoeteroids:factors affecting the risks of systemic adverse effects[J].Pharmacol Ther,1999,83(3):153-179.
[11]申昆玲,邓力,李云珠,等.支气管舒张剂在儿童呼吸道常见疾病中应用的专家共识(2015年版)[J].临床儿科杂志,2015,33(4):373-375.
[12]朱小玉.特布他林及沙丁胺醇吸入疗法对儿童轻度及中度哮喘发作效果的对比[J].国际内科学杂志,2005,32(8):368-368.
[13]王顺培.β2受体激动剂在儿童支气管哮喘治疗中的合理应用[J].实用医学杂志,2012,28(5):848-850.
[14]尚云晓,黄英,刘恩梅,等.雾化吸入重组人干扰素α1b治疗小儿急性毛细支气管炎多中心研究[J].中国实用儿科学,2014,29(11):840-844.
[15]宁亚灵,杨月敏,成佳文.重组人干扰素α1b联合丙酸氟替卡松治疗毛细支气管炎的临床研究[J].现代药物与临床,2018,33(8):1974-1977.
[16]洪建国,陈强,陈志明,等.儿童常见呼吸道疾病雾化吸入治疗专家共识(2012年)[J].中国实用儿科杂志,2012,27(4):265-269.
[17]李明华,段楷生,蔡映云.哮喘病学[M].第2版.北京:人民卫生出版社,2005:286-295.