晚期非小细胞肺癌患者化疗用药合理性评估  

Rationality assessment of postoperative chemotherapy in patients with advanced non-small cell lung cancer

作　　者：张晋萍[1] 周丹丽[2] 曹慧[3] 王坚[4] 朱楷建 ZHANG Jin-ping ZHOU Dan-li CAO Hui WANG Jian ZHU Kai-jian(Department of Pharmacy, Affilia- ted Drum Tower Hospital of Nanjing University Medical School, Jiangsu Nanjing 210008, China Department of Clinical Pharmacy,Children~ s Hospital of Wuxi, Jiangsu Wuxi 214002, China China Pharmaceutical University, Jiangsu Nanjing 210003, China Department of Pharmacy, Second Hospital of Nanjing, J iangsu Nanjing 210003, China Department of Clini- cal Pharmacy,Jiangsu Huaiyin Hospital,Jiangsu Huai＇an 223300,China)

机构地区：[1]南京大学医学院附属鼓楼医院药学部,江苏南京210008 [2]无锡市儿童医院药剂科,江苏无锡214002 [3]中国药科大学,江苏南京210009 [4]南京市第二医院药剂科,江苏南京210003 [5]淮安市淮阴医院药剂科,江苏淮安223300

出　　处：《中国医院药学杂志》2017年第13期1309-1314,共6页Chinese Journal of Hospital Pharmacy

基　　金：江苏省药学会医院药学科研基金(编号:201311)

摘　　要：目的:评价晚期非小细胞肺癌患者药物治疗方案的合理性,以期为临床合理用药提供参考。方法:收集2014年4月—2015年3月某院收治的120例非小细胞肺癌患者资料,统计患者化疗方案、辅助用药、治疗过程监测以及化疗相关不良反应情况。结果:120例患者共使用11种含铂两药化疗方案,以吉西他滨联合奈达铂的治疗方案用药频度最高,构成比为28.08%。有43例次化疗中,一种化疗药超剂量使用。6种辅助用药DUI>1。中药注射剂与止吐药用药频度最高,分别为3 754.8 DDD和3 985.0DDD。盐酸托烷司琼注射液、注射用埃索美拉唑和和痰热清注射液的药物利用指数居前三位,分别为1.8、1.4和1.4。在药物选择、给药剂量、配置浓度以及异常检验指标的复查方面,存在一些有待改进之处。结论:某院晚期非小细胞肺癌的药物治疗方案基本贯彻指南要求,但在给药剂量、治疗过程监测、中药注射剂的使用方面仍需进一步规范。OBJECTIVE To evaluate the medication rationality in postoperative chemotherapy patients with advanced nonsmall cell lung cancer（NSCLC）,provide evidences for rational medication.METHODS Data of 120 patients with advanced NSCLC were collected,who were inpatients from April 2014 to March 2015.The medication of chemotherapy regimens,the adjuvant drugs,the therapeutic process monitoring and adverse drug reactions（ADRs）were analyzed retrospectively with the methods of drug use evaluation（DUE）and drug use review（DUR）.RESULTS Eleven kinds of two-drug regimens involving platinum were used to treat 120 patients.Gemcitabine together with nedaplatin was used most frequently,accounting for 28.08%.Forty three cases of overdose occurred.Among adjuvant drugs,DUI of 6 drugs was more than 1.The utilization frequencies of Traditional Chinese Medicine（TCM）injections and antiemetic medicine were high,up to 3 754.8 DDD and 3 985 DDD,respectively.The DUI values of tropisetron hydrochloride injection,esomeprazole injection and Tanreqing injection were the top three,up to 1.8,1.4 and 1.4.It was necessary to improve the rationality of drug selection,dosage,concentration and the review of abnormal indicators.CONCLUSION Medication treatment of advanced NSCLC in the hospital should be implemented according to the guidelines basically.Meanwhile,the dosage,the therapeutic process monitoring and the use of Traditional Chinese Medicine still need to be improved in the future.

关 键 词：非小细胞肺癌 化疗方案 辅助用药 合理性评价 

分 类 号：R969[医药卫生—药理学]