注射用氯诺昔康所致不良反应的相关因素和帕累托图分析  

Pareto Chart Analysis of Related Factors of Lornoxicam for Injection-Induced Adverse Drug Reactions

作　　者：马超[1] 崔喜凤[1] 张树荣[1] 李春钰[1] 李凤云[1] Ma Chao Cui Xifeng Zhang Shurong Li Chunyu Li Fengyun(Beijing Fengtai Hospital, Beijing 100071, China)

机构地区：[1]北京丰台医院,北京100071

出　　处：《中国药事》2017年第7期807-813,共7页Chinese Pharmaceutical Affairs

摘　　要：目的:分析注射用氯诺昔康致不良反应(ADR)的相关因素和特点,为临床更加合理使用该药提供依据。方法:汇集2006年1月-2015年12月,北京10个区县关于注射用氯诺昔康的ADR报告,并对患者的年龄、性别、ADR发生时间、用药方法、使用剂量与ADR累及系统等进行相关因素分析和帕累托图分析。结果:共收集注射用氯诺昔康ADR病例103例,符合要求病例88例:患者平均年龄48岁,多为中老年患者;男性55例(占62.5%),女性33例(占37.5%);出现ADR最长用药时间为14 d,最短用药时间为5 min内;有75例首次用药即发生ADR,占85.23%;累及系统分为9种类型,其中以皮肤和胃肠道损害多见;合理使用剂量以8 mg/次、1次/d居多,占64.77%;超说明书用药中,有25例为16 mg/次,1次/d,占28.41%;有5例24 mg/次,1次/d,占5.68%,有1例32 mg/次,2次/d,占1.14%。结论:ADR发生率与患者的年龄、性别、用法用量及超说明书用药等因素有一定关系,尤其是中老年患者在应用氯诺昔康时应格外注意。临床药师在工作中应做好合理用药的宣传教育,加强用药监护,确保注射用氯诺昔康的用药安全。Objective： To analyze related factors and the characteristics of lornoxicam for injection-induced adverse drug reactions（ADRs）so as to provide a basis for more rational use of the drug. Methods：Cases of lornoxicam for injection-induced ADRs of 10 counties of Beijing from January 2006 to December 2015 were collected. Related factors including ages of the patients, gender, ADRs occurrence time, medication methods, dosage, as well as systems involved in ADR were analyzed and Pareto chart analysis was conducted. Results：A total of 103 cases of lornoxicam for injection-induced ADRs were collected, and 88 cases were qualified. The average age of patients was 48 years old, most of which were middle-aged patients. 55 cases were male（62.5%）, and 33 cases were female（37.5%）. The longest medication time before ADRs was 14 days and the shortest medication time was less than 5 minutes. There were 75 cases with ADRs occurring at the first administration, accounting for 85.23%. There were 9 types of systems involved in ADRs, among which skin and gastrointestinal damages were more common. A majority of rational dose was 8 mg, once per day, accounting for 64.77%. As far as the off-label drug use was concerned, 25 cases were given 16 mg, once per day, accounting for 28.41%; 5 cases were given 24 mg, once per day, accounting for 5.68%; 1 case was given 32 mg, twice a day, accounting for 1.14%.Conclusion：The incidence of ADRs was related to age, gender, usage and dosage, as well as off-label drug use. More attention should be especially paid to elderly patients who were injected lornoxicam. Clinical pharmacists should make publicity and education of the rational drug use, strengthen medication monitoring so as to ensure the safety use of the lornoxicam for injection.

关 键 词：注射用氯诺昔康 不良反应 帕累托图 分析 合理用药 临床药师 用药监护 

分 类 号：R969.3[医药卫生—药理学]