采用循证药学干预后住院支气管肺炎患儿的用药合理性分析  

Rationality of drug use in children with bronchial pneumonia after evidence-based intervention

作　　者：刘建红[1] 喻佳洁[2] 谢勇[3] 李幼平[2] 张卫东[1] 徐珽[4] 吴民[1] 卢静[4] 李潇[1] Liu Jianhong;Yu Jiajie;Xie Yong;Li Youping;Zhang Weidong;Xu Ting;Wu Min;Lu Jing;Li Xiao(Department of Pharmacy,Karamay Central Hospital,Xinjiang Uygur Autonomous Region,Karamay 834000,Chin;Chinese Evidence-Based Medicine Center,West China Hospital,Sichuan University,Chengdu 610041,Chin;Department of Pediatrics,Karamay Central Hospital,Xinjiang Uygur Autonomous Region,Karamay 834000,China;Department of Pharmacy,West China Hospital,Siehuan University,Chengdu 610041,China)

机构地区：[1]新疆维吾尔自治区克拉玛依市中心医院药学部,834000 [2]四川大学华西医院中国循证医学中心,成都610041 [3]新疆维吾尔自治区克拉玛依市中心医院儿科,834000 [4]四川大学华西医院药剂科,成都610041

出　　处：《中国医药》2018年第11期1646-1650,共5页China Medicine

基　　金：新疆维吾尔自治区科技支疆项目(201591161)~~

摘　　要：目的调查循证药学干预后住院支气管肺炎患儿的用药合理性。方法提取克拉玛依市中心医院2016年1月1日至12月31日第一诊断是支气管肺炎的出院儿童的病历资料中的住院费用和用药信息等数据。基于既往2014年的统计资料,分析2016年采用循证药学干预后患儿的住院天数和用药情况等,比较循证药学干预前后的临床用药合理性。结果 2016年(904例)的人均住院天数较2014年(890例)明显缩短[(6.1±2.1)d比(7.1±2.6)d](P<0.001)。2016年的人均用药品种数较2014年减少[(7.1±2.2)种比(8.3±3.5)种]。2016年联合使用抗菌药物者占比较2014年下降了12.27%。2016年使用硫酸沙丁胺醇片和氨茶碱片者仅占1. 34%(11/820),下降了83. 97%。2016年使用的糖皮质激素中注射用甲泼尼龙琥珀酸钠仅占8.91%(80/898),下降了76.74%。结论通过采取循证药学干预,调整临床路径,支气管肺炎患儿的住院天数、用药品种数、抗菌药物联合用药和注射用糖皮质激素的不合理用药情况得到很大改善。Objective To investigate the rationality of drug use in children with bronchial pneumonia after evidence-based intervention. Methods Medical records of children with the first diagnosis of bronchial pneumonia who discharged between 1st, January and 31st, December in 2016 in Karamay Central Hospital were extracted from the electronic medical record database. Evidence-based medication intervention was performed during 2016 based on the statistical data in 2014. Hospitalization time, expenses and medication information were analyzed. The improvement of medication reasonableness was analyzed between 2014 and 2016. Results After the intervention, per capita hospitalization time in 2016（n=904） was significantly shorter than that in 2014（n=890）[（6.1±2.1）d vs （7.1±2.6）d]（P〈0.001）; per capita drug species in 2016 were less than those in 2014[（7.1±2.2） vs （8.3±3.5）]. In 2016, the combined use rate of antimicrobial agents fell by 12.27% compared to that in 2014. The use ratio of salbutamol sulfate tablets and aminophylline tablets was 1.34%（11/820） in 2016, which fell by 83.97% compared to that in 2014. The use ratio of methylprednisolone sodium succinate for injection was 8.91%（80/898） in 2016, which fell by 76.74% compared to that in 2014. Conclusion sEvidence-based intervention helps adjust clinical pathway and promote rational drug use in children with bronchial pneumonia. After evidence-based practice, hospitalization days and drug species decrease; irrational drug uses such as antibacterial combination and glucocorticoid for injection are improved.

关 键 词：支气管肺炎 合理用药 循证药学干预 

分 类 号：R563.1[医药卫生—呼吸系统]