我院慢性肾功能不全患者合理用药情况调查及典型案例分析
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摘要
目的调查焦作市第二人民医院(以下简称"本院")慢性肾功能不全患者药物使用情况,为促进该类患者合理用药提供参考。方法采用回顾性调查方法,收集本院2017年1月-2018年6月出院的慢性肾功能不全患者1023例,对不合理用药科室分布、不合理用药类型、不合理药物种类进行帕累托图分析,并对不合理用药典型案例进行评价。结果 1023例慢性肾功能不全患者中,314例存在不合理用药问题,不合理率为30.69%;不合理用药科室方面,肾病科不合理用药问题最多,占不合理用药例数的29.30%;不合理用药类型方面,用法用量不适宜所占的比例最大,占32.17%;不合理药物种类方面,抗菌药物所占比例最大,为35.67%。结论慢性肾功能不全患者用药存在诸多问题,应采取多项举措共同干预,持续为患者合理用药保驾护航。
Objective To provide a reference for reasonable drug use in patients with chronic renal impairment through the investigation of drug use. Methods A total of 1023 patients with chronic renal impairment of medical records were retrospectively analyzed from January 2017 to June 2018, and Pareto chart analysis was performed by investigating departments with irrational medication use, types of irrational drug use and drug categories. In addition, the typical cases of irrational drug use were evaluated. Results Among the 1023 patients, 314(30.69%) had irrational drug use. In the department with irrational use, the one with the most irrational use of medicine is Nephrology Department, accounting for 29.30%. The proportion of unsuitable usage and dosage accounted for 32.17%. Among the unreasonable drug types, antibacterial drugs occupied the largest proportion(35.67%). Conclusion There are many problems in the drug use in patients with chronic renal impairment. Measures should be taken to ensure rational use of drugs among such patients.
Objective To provide a reference for reasonable drug use in patients with chronic renal impairment through the investigation of drug use. Methods A total of 1023 patients with chronic renal impairment of medical records were retrospectively analyzed from January 2017 to June 2018, and Pareto chart analysis was performed by investigating departments with irrational medication use, types of irrational drug use and drug categories. In addition, the typical cases of irrational drug use were evaluated. Results Among the 1023 patients, 314(30.69%) had irrational drug use. In the department with irrational use, the one with the most irrational use of medicine is Nephrology Department, accounting for 29.30%. The proportion of unsuitable usage and dosage accounted for 32.17%. Among the unreasonable drug types, antibacterial drugs occupied the largest proportion(35.67%). Conclusion There are many problems in the drug use in patients with chronic renal impairment. Measures should be taken to ensure rational use of drugs among such patients.
引文
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[11]国家卫生计生委合理用药专家委员会,中国医师协会高血压专业委员会.高血压合理用药指南[J].中国医学前沿杂志(电子版),2015,7(6):22-64.
[12]倪寂,冯伟民,范婷. 2016年某院蔗糖铁注射液临床使用评价与分析[J].中国药房,2017,26(22):89-92.
[13]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[J].中华医学杂志,2016,96(34):2696-2708.
[14]彭洋,黄琪,曹俊华,等.我院2013年维生素K1注射液的用药调查分析[J].中国药房,2014,25(30):2809-2812.
[15]王春婷.别嘌醇致中毒性表皮坏死松解症的风险因素分析与措施[J].中国药物警戒,2014,11(8):485-487.
[16]中国慢性肾脏病患者合并高尿酸血症诊治共识专家组.中国慢性肾脏病患者合并高尿酸血症诊治专家共识[J].中华肾脏病杂志,2017,33(6):463-469.
[17]徐翠玲.静脉应用蔗糖铁致静脉炎原因分析及护理对策[J].全科护理,2011,9(3):619.
[18]宋丽娜.蔗糖铁注射液致静脉炎的原因分析及防护[J].总装备部医学学报,2010,12(1):40-42.
[19]姜玲,史天陆.肾功能不全患者治疗临床药师指导手册[M].北京:人民卫生出版社,2014:52.
[2]Caldas HC,de Paula Couto TA,Fernandes IM,et al.Comparative effects of mesenchymal stem cell therapy indistinctstagesofchronicrenalfailure[J].ClinExp Nephrol,2015,19(5):783-789.
[3]许敏,吴巧稚.肾功能不全患者应用抗菌药物的剂量调整[J].中国医院用药评价与分析,2017,17(2):257-258,262.
[4]王霞,吴胜林,王懿睿,等.慢性肾功能不全患者使用抗菌药物的情况分析[J].中国医院药学杂志,2013,33(24):2082-2083.
[5]国家卫生计生委医政医管局,国家卫生计生委合理用药专家委员会.国家抗微生物治疗指南(第2版)[M].北京:人民卫生出版社,2017:256.
[6]邓立新,韩方璇,云雄,等.肾功能不全患者使用抗菌药物合理情况调查[J].医药导报,2015,34(5):676-680.
[7]闫佳佳.低剂量美罗培南在CVVH治疗无尿患者药代动力学与药效动力学[D].济南:山东大学,2010.
[8]卫生部合理用药专家委员会.中国医师药师临床用药指南(第1版)[M].重庆:重庆出版社,2009:85.
[9]陈新谦,金有豫,汤光.新编药物学[M]. 17版.北京:人民卫生出版社,2011:809.
[10]李航,刘立立,陈路佳,等.复方氨基酸注射液的临床合理使用[J].中国药业,2014,23(5):57-58.
[11]国家卫生计生委合理用药专家委员会,中国医师协会高血压专业委员会.高血压合理用药指南[J].中国医学前沿杂志(电子版),2015,7(6):22-64.
[12]倪寂,冯伟民,范婷. 2016年某院蔗糖铁注射液临床使用评价与分析[J].中国药房,2017,26(22):89-92.
[13]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[J].中华医学杂志,2016,96(34):2696-2708.
[14]彭洋,黄琪,曹俊华,等.我院2013年维生素K1注射液的用药调查分析[J].中国药房,2014,25(30):2809-2812.
[15]王春婷.别嘌醇致中毒性表皮坏死松解症的风险因素分析与措施[J].中国药物警戒,2014,11(8):485-487.
[16]中国慢性肾脏病患者合并高尿酸血症诊治共识专家组.中国慢性肾脏病患者合并高尿酸血症诊治专家共识[J].中华肾脏病杂志,2017,33(6):463-469.
[17]徐翠玲.静脉应用蔗糖铁致静脉炎原因分析及护理对策[J].全科护理,2011,9(3):619.
[18]宋丽娜.蔗糖铁注射液致静脉炎的原因分析及防护[J].总装备部医学学报,2010,12(1):40-42.
[19]姜玲,史天陆.肾功能不全患者治疗临床药师指导手册[M].北京:人民卫生出版社,2014:52.