某院肝胆外科手术患者质子泵抑制剂用药情况的分析  

Analysis on medication of proton-pump inhibitor for the patients subject to hepatobiliary surgery

作　　者：陈华玲[1] 朱贲贲 马晓鹂[2] 

机构地区：[1]广东医学院药理教研室,广东湛江524023 [2]广东医学院附属医院,广东湛江524001

出　　处：《广东医学院学报》2016年第1期61-64,共4页Journal of Guangdong Medical College

基　　金：广东省自然科学基金(No.S2012010008145)

摘　　要：目的分析某院肝胆外科质子泵抑制剂(PPIs)的临床合理用药情况。方法随机抽查该院住院病区2014年1-12月份内肝胆外科使用PPIs的手术患者电子病历933份,对PPIs的预防应用指征、给药途径、术前术后、疗程及更换药物的合理性进行评价。结果 933例病例中,肝胆外科最易患有的疾病是胆囊结石(26.58%)、肝胆管结石(20.04%)、肝癌(19.72%)。PPIs使用率最高的前3名是泮托拉唑针40 mg(29.35%)、兰索拉唑针60 mg(19.76%)、泮托拉唑针80 mg(18.54%)。7种PPIs中,使用注射剂的比率高达87.87%,只使用2种口服制剂。泮托拉唑针、奥美拉唑针、兰索拉唑针都是术后给药居多,埃索美拉唑镁肠溶片术前和术后使用差别不大。泮托拉唑针用药疗程偏长,最长达23 d。结论 PPIs使用疗程偏长、更换使用PPIs频繁及注射剂型使用过多可能是造成PPIs过度使用的主要原因,应建立合理使用PPIs指南,进一步改善PPIs不合理用药现状。Objective To investigate the clinical rational application of proton pump inhibitors（PPIs） for hepatobiliary surgery in a hospital. Methods 933 medical records of the patients in Hepatobiliary Surgery Department in 2014 using PPIs were randomly chosen, and preventive application indication for PPIs, administration route, pre- and post-operation, course of treatment and rationality of drug change were evaluated. Results Of 933 cases, the most common diseases in Hepatobiliary Surgery Department were gallbladder stones（26.58%）, liver bile duct stones（20.04%） and liver cancer（19.72%）. The top three drugs with the highest usage rate of PPIs were 40 mg pantoprazole injection（29.4%）, 60 mg lansoprazole injection（19.76%）, and 80 mg pantoprazole injection（18.54%）. Of Seven kinds of PPIs, the proportion of injection usage was up to 87.87%, and only two kinds of oral preparations were used. Pantoprazole injection, omeprazole injection and lansoprazole injection were mostly administered after operation. There was little difference in the use of esomeprazole magnesium enteric coated tablets before and after operation. The course of medication of pantoprazole injection was relatively long, and could be up to 23 days. Conclusion A long course of PPIs usage, frequently change of PPIs and too many dosage forms of injection may be the main reason for excessive use of PPIs. It is suggested to establish guidelines for the rational use of PPIs, so as to further improve the irrational use of PPIs.

关 键 词：肝胆外科 质子泵抑制剂 合理用药 

分 类 号：R573.1[医药卫生—消化系统]