我院住院患者乌司他丁应用情况分析及评价  

Analysis and evaluation of ulinastatin application in inpatients of our hospital

作　　者：王心慧[1] 薛静静[1] 周亮[1] 王明媚[1] 张鑫[1] 王晓青[1] 卫晋菲[1] 

机构地区：[1]解放军总医院第一附属医院药剂药理科,北京100048

出　　处：《实用药物与临床》2017年第5期581-585,共5页Practical Pharmacy and Clinical Remedies

摘　　要：目的分析我院乌司他丁使用情况,促进临床应用合理化。方法利用院内信息系统调取2016年1-3月期间使用乌司他丁的出院患者,统计患者性别、年龄、适应证、给药途径、剂量、溶媒、用药疗程、转归、乌司他丁金额和住院总药费,并查阅相关文献,分析评价其合理性。结果943例使用乌司他丁的出院患者中,男487例,女456例,平均年龄(49.80±17.75)岁,全院平均药物利用指数DUI合理(0.28),乌司他丁药占比为2.91%。平均单次给药剂量为(23.48±5.88)万U,平均日剂量(29.44±13.75)万U,平均用药疗程为(1.89±1.77)d。乌司他丁医嘱共1 063条,完全符合说明书适应证用药的38条,超适应证用药1 025条,集中于围手术期用药1 013条。超适应证用药中有较高质量文献支持适应证的医嘱708条(69.1%),无文献或文献质量较低的317条(30.9%)。出院患者治愈率60.87%,好转率37.22%,死亡率1.91%。结论乌司他丁超适应证应用现象较为普遍,虽然患者转归较好,但合理应用仍需要更多高质量文献支持。Objective To analyze the use of ulinastatin in our hospital to promote rational clinical application. Methods The discharged patients who received ulinastatin treatment during January to March 2016 in our hospital were retrieved by hospital information system; sex and age of patients, indications, administration, dosage, solvent, course of treatment, prognosis, costs of ulinastatin and total hospitalization medicine expenses were collected, and rele- vant literature was referred to evaluate the rationMity of ulinastatin application. Results Ulinastatin was used in 943 discharged patients ,487 males and 456 females, mean age （ 49. 80 ± 17. 75 ） years old ; the average drug utilization index DUI （0. 28 ） was appropriate, and the cost of ulinastatin accounted for 2. 91% of total medicine cost. The average single dosage was （23.48 ± 5. 88 ） ×10^4 unit, average daily dosage was （ 29. 44 ±13.75 ） ×10^4 unit, and the average course of treatment was （ 1.89± 1.77 ） days. Totally 1 063 prescriptions of ulinastatin were collected, of which 38 fully complied with drug instruction, and 1 025 were off-label indications;the largest proportion of ulinastatin were presicribed in perioperative period （ 1 013 ）. The off-label use of ulinastatin with high quality literature support was 708 （69. 1% ） , while 317 （30. 9% ） was without evidence or with low quality support. Of discharged patients, the cure rate was 60. 87% ,the improvement rate was 37. 22% ,and the mortality rate was 1.91%. Conclusion Off-label indication use of ulinastatin is a common phenomenon ; although most patients have good prognosis, the reasonable application still needs more high quality literature to support.

关 键 词：乌司他丁 超说明书 合理化 

分 类 号：R977.6[医药卫生—药品]