我院肿瘤患者止吐药物使用合理性与疗效分析  

Analysis of Rationality and Therapeutic Efficacy of Antiemetics in Cancer Patients of Our Hospital

作　　者：江彦[1] 宋洪涛[1] 

机构地区：[1]南京军区福州总医院药学科,福州350025

出　　处：《中国药房》2017年第5期602-606,共5页China Pharmacy

摘　　要：目的:为肿瘤患者止吐药物的合理使用提供参考。方法:通过医院集成医疗终端管理系统(EMRS)收集我院肿瘤科2015年10月-2016年6月使用止吐药物患者的医嘱共2 616份,对其使用合理性进行统计分析并评价其疗效。结果:在调查的2 616例病例中,符合纳入排除标准的病例有1301例,其中595例、合计760例次患者存在不合理用药现象,主要包括药物选择不适宜(33.82%)、用法用量不合理(25.26%)、联合用药不恰当(34.08%)、用药疗程不规范(6.84%)。女性患者的恶心发生率高于男性,差异有统计学意义(P=0.003),而不同性别患者的呕吐发生率则差别不大(P>0.05);不同年龄患者的恶心、呕吐发生率均差别不大(P>0.05);合理用药组的恶心、呕吐控制率均高于不合理用药组。不同催吐风险化疗药物止吐治疗合理用药组的成本均值均低于不合理用药组,提示止吐药合理使用能在保证治疗效果的同时减轻患者的经济负担。结论:临床应根据化疗药的催吐风险分级合理选用止吐方案,联合化疗患者应根据最高催吐风险的化疗药物选择止吐方案,严格掌握止吐药用法用量和疗程,并在选择止吐方案时综合考虑患者的治疗费用,保障患者用药安全、有效、经济、合理。OBJECTIVE：To provide reference for rational use of antiemetics in cancer patients.METHODS：Two thousand six hundred and sixteen pieces of medical orders of patients receiving antiemetics were collected from oncology department of our hospital via EMRS during Oct.2015-Jun.2016.RESULTS：Among 2 616 cases surveyed,1 301 cases conformed to inclusion and exclusion criteria,of which irrational use of drugs were found in 595 cases,760 times in total.Main manifestations were unsuitable drug selection（33.82%）,irrational usage and dosage（25.26%）,unsuitable drug combination（34.08%） and non-standard medication course（6.84%）.The incidence of nausea in female was higher than male,with statistical significance（P=0.003）,but gender had no significant effect on the incidence of nausea（P0.05）.Age had no significant effect on both nausea and vomiting（P0.05）.The control rate of nausea/vomiting in rational drug use group was higher than irrational drug use group.Average cost of antiemetic treatment of different emetic risk chemotherapy drugs in rational drug use group were all lower than irrational drug use group,indicating therapeutic efficacy could be guaranteed and economic burden was reduced in rational drug use group.CONCLUSIONS：The antiemetic plan should be selected rationally according to emetic risk degree of chemotherapy drugs.Patients receiving combined chemotherapy should select antiemetic plan according to highest emetic risk degree of chemotherapy drugs,and strictly master usage,dosage and duration.At the same time,treatment cost should be considered when selecting antiemetic plan to guarantee the safe,effective,economical and rational use of drugs.

关 键 词：化疗 止吐药物 合理用药 疗效 

分 类 号：R975.4[医药卫生—药品] R969.3[医药卫生—药学]