静脉用药调配中心建立前后抗肿瘤药物引起护士血液毒性评估  

Assessments Blood Toxicity of Nurses Exposed to Anti-tumor Drugs before and after Establishment of PIVAS

作　　者：张晓霞[1] 马文兵[1] 姜媛媛[1] 郑巧伟[1] 张亚婷[1] 董卫华[1] 封卫毅[1] 

机构地区：[1]西安交通大学第一附属医院,西安710061

出　　处：《药物流行病学杂志》2017年第12期823-826,共4页Chinese Journal of Pharmacoepidemiology

基　　金：陕西省自然科学基金项目(编号:2015JM8478)

摘　　要：目的:对比某两所三级甲等医院(A医院和B医院)建立静脉用药调配中心(PIVAS)前后抗肿瘤药物(AD)暴露对护士血液系统的健康风险,以评估建立PIVAS后AD对护士血液系统带来的影响。方法:选取A医院建立PIVAS前(2011年)、建立PIVAS后(2013年)未使用AD的科室(第1组)、使用AD的其他科室(非肿瘤科,第2组)、肿瘤科(第3组)和未建立PIVAS的B医院2013年肿瘤科(第4组)护士的AD接触记录和体检报告,其中血液系统的相关检验数据包括:白细胞(WBC)、血小板(Plt)和红细胞(RBC)计数,分析建立PIVAS前后不同的AD暴露状况对以上指标的影响。结果:与同组建立PIVAS前比较,建立PIVAS后第2组、第3组每名护士每周接触AD袋数的差异均无统计学意义(P>0.05);第4组和建立PIVAS后第3组比较,每名护士每周接触AD袋数的差异无统计学意义(P>0.05)。建立PIVAS前,与第1组和第2组比较,第3组护士的WBC计数较低(P<0.01);建立PIVAS后第3组护士血液系统的损伤降低,且WBC、Plt和RBC计数高于第4组(P<0.01)。结论:在肿瘤科护士中,与未暴露在AD作用下的护士相比,AD暴露的可能对护士血液系统有损害。PIVAS的建立及运行在很大程度上降低了AD暴露引发的护士血液系统损害的风险。Objective：To assess risks of anti-tumor drug （AD） for the blood system of nurse betore and alter es- tablishment intravenous drug control center （PIVAS） by comparing with two third grade hospital, and to evaluate the im- pact of AD on the blood system of nurses. Methods：The record of drug dispensing and medical reports of nurses working for unused AD departments （the first group）, other used AD departments （the second group）, oncology department （the third group） in the A hospital which before （2011 ） and after PIVAS established（2013 ）, and oncology department in the B hospital （the fourth group） which PIVAS had not established were all collected. The blood system test data included WBC, Pit and RBC. The effects of different AD exposures on the above indices were analyzed. Results ： Before and after establish- ment of PIVAS, there was no statistical significance of AD exposure of each nurse in the second group or the third group （P 〉 0.05）. There were no statistical significance in AD exposure of each nurse between the fourth group and the third group after establishment of PIVAS （P 〉 0.05）. Before establishment of PIVAS, nurses in the third group had lower WBC counts than those in the first group and the second group （P 〈 0.01 ）. After establishment of PIVAS, the damage to blood system of nurses in the third group was reduced, and the counts of WBC, PITand RBC were higher than that of the fourth group（P 〈 0.01 ）. Conclusion： In oncology department, compared with nurses who were not exposed to anti-tumor drugs, AD expo- sure could impair blood systems in nurses. The establishment and operation of PIVAS had greatly reduced the risk of the damage to nurses＂ blood system caused by AD exposure.

关 键 词：静脉用药调配中心 抗肿瘤药物 血液系统 药品风险管理 

分 类 号：R979.1[医药卫生—药品]